PSA level of 11.75?
My father (57 years old) experienced testicular pain when straining about a month and a half ago and sought consultation from a urologist.
However, the treatment so far has not been effective, and his urinalysis results were normal and sterile.
An ultrasound examination revealed benign prostatic hyperplasia, which the doctor attributed to natural aging.
Last week, my father requested a blood test, and the PSA level was found to be as high as 11.75.
The doctor mentioned that there could be many reasons for this and suggested waiting a week to repeat the test.
However, my father was diagnosed with stage 4 nasopharyngeal carcinoma (NPC) three years ago and has been recovering well since treatment, although he seems to be suffering from post-traumatic stress disorder.
Now, my father subconsciously believes he has prostate cancer, leading to constant anxiety and even making end-of-life arrangements, which has caused chaos in the family.
I am unable to focus on my work and would like to ask if my father, who still only has testicular pain and normal urination, has a high probability of having a malignant tumor given the PSA level of 11.75? Additionally, considering my father's anxious and irritable personality, would it be advisable to consult a psychiatrist? Thank you for your response, doctor.
Niming, 20~29 year old female. Ask Date: 2017/08/02
Dr. Du Shixi reply Urology
Hello: A PSA level greater than 10 indicates a possibility of 1 in 2 to 1 in 3 for prostate cancer.
To confirm the diagnosis, a biopsy is necessary; however, there are some potential complications associated with the biopsy, which you can research online.
It may also be beneficial to increase your physical activity (such as walking) and maintain a light diet.
I also recommend having another blood test to confirm if the PSA level is still elevated, and do not rush into the biopsy.
Wishing you good health.
Reply Date: 2017/08/02
More Info
Elevated PSA levels can indeed be a source of significant anxiety, especially in individuals with a history of cancer, such as your father, who has previously been diagnosed with stage 4 nasopharyngeal carcinoma (NPC). Understanding the implications of a high PSA level, such as the 11.75 reading in your father's case, is crucial for both medical management and emotional support.
Firstly, it is important to note that a PSA (Prostate-Specific Antigen) level above 10 ng/mL does raise concerns about the possibility of prostate cancer, but it does not confirm it. Studies suggest that the likelihood of prostate cancer in men with PSA levels between 10 and 20 ng/mL is approximately 50-66%. However, elevated PSA levels can also result from benign conditions such as benign prostatic hyperplasia (BPH), prostatitis (inflammation of the prostate), or even recent sexual activity. Given your father's age and the ultrasound findings indicating prostate enlargement, it is plausible that his elevated PSA could be related to BPH rather than malignancy.
The recommendation to repeat the PSA test after a week is a standard practice to confirm the elevation and rule out any transient causes. If the PSA remains elevated, further diagnostic steps, such as a prostate biopsy, may be warranted to definitively determine the presence of cancer. While biopsies can have risks, including infection and bleeding, they are essential for accurate diagnosis when cancer is suspected.
Regarding your father's anxiety, it is understandable given his medical history and the current situation. Anxiety can significantly impact one's quality of life and can exacerbate physical symptoms. It is essential to address both the medical and psychological aspects of his health. A referral to a mental health professional, such as a psychiatrist or psychologist, could be beneficial. They can provide strategies to manage anxiety, including cognitive-behavioral therapy (CBT), which has been shown to be effective for anxiety disorders, especially in patients dealing with chronic illness.
In addition to professional help, consider encouraging your father to engage in activities that promote relaxation and well-being, such as light exercise, mindfulness practices, or hobbies he enjoys. Family support is also crucial; open communication about fears and concerns can help alleviate some of the emotional burden he is experiencing.
In summary, while a PSA level of 11.75 raises concerns, it is not definitive for prostate cancer, and further testing is necessary. Addressing your father's anxiety through professional support and family involvement is equally important to help him cope with this challenging time. It is essential to take a holistic approach to his health, considering both physical and mental well-being.
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