Chronic Perineal Pain: Seeking Solutions Beyond Urology Consultations
Perineal pain Hello, doctor. I have been experiencing persistent left-sided perineal pain, along with a sensation of urinary urgency, frequent urination, and pain during ejaculation. I have consulted urologists multiple times and have undergone PSA tests and urinalysis, all of wh...
Dr. Du Shixi Reply:
Hello: If the symptoms are severe, please seek medical attention at a medical center. If multiple physicians find no abnormalities, it may not necessarily be a urological issue. The examination items should be determined by the examining physician. Wishing you good health.[Read More] Chronic Perineal Pain: Seeking Solutions Beyond Urology Consultations
Can MRI Detect Prostate Cancer After Surgery? Understanding PSA Testing
Prostate cancer Thank you very much for Dr. Jian's response. I would like to ask if cancer cells can be detected on an unremoved prostate using MRI-PET scans. My father has undergone this examination, and the results showed no issues. After his prostate laser surgery, he fel...
Dr. Jian Weihong Reply:
Hello: MRI can be referenced, but it is generally recommended to wait for a period of time before surgery, as it may affect the interpretation even if a stent has been placed. In addition to medication, lifestyle habits should be taken into consideration. First, identify the caus...[Read More] Can MRI Detect Prostate Cancer After Surgery? Understanding PSA Testing
Understanding Elevated PSA Levels and Prostate Cancer Treatment Options
Elevated PSA Levels and Cancer Treatment Hello Doctor: My father is 70 years old. At the end of last year, he was referred to a major hospital due to elevated PSA levels and urinary difficulties detected at a clinic. The physician recommended laser surgery to treat benign prostat...
Dr. Jian Weihong Reply:
Hello: 1. The PSA level has been elevated for over two months following surgery. Although surgery and inflammation can cause an increase, it should ideally decrease. If inflammation is present, it should be well-controlled. Additionally, what is the current assessment of the tu...[Read More] Understanding Elevated PSA Levels and Prostate Cancer Treatment Options
Understanding BPH Treatment and Cancer Risks in Older Patients
Treatment for Benign Prostatic Hyperplasia (BPH) Hello Doctor: My father is 70 years old. At the end of last year, he was referred to a major hospital due to elevated PSA levels and urinary difficulties detected at a clinic. The doctor recommended laser surgery to treat benign pr...
Dr. Du Shixi Reply:
Hello: 1. The PSA level has been elevated for over two months due to surgery. While surgery and inflammation can cause an increase, it should generally decrease. If inflammation is present, it should be well-managed. Additionally, what is the current stage of the tumor? This is...[Read More] Understanding BPH Treatment and Cancer Risks in Older Patients
Understanding Prostate Cancer Staging: Implications of Perineural Invasion
Prostate cancer I underwent a Da Vinci radical prostatectomy for prostate cancer, and the pathology report indicates pT2N0, grade 2, Gleason 3+4, Stage IIB. However, there are additional findings of perineural invasion: Present. I preserved one side of the neurovascular bundles, ...
Dr. Jian Weihong Reply:
Hello: You have localized prostate cancer (stage T1-2 N0), which is classified as localized prostate cancer. Your pathology report indicates stage 2B. Wishing you good health.[Read More] Understanding Prostate Cancer Staging: Implications of Perineural Invasion
Understanding Prostate Cancer Staging After Da Vinci Surgery: Key Insights
Da Vinci Prostate Cancer Radical Surgery I underwent a Da Vinci radical prostatectomy for prostate cancer, and my pathology report indicates pT2N0, grade 2, Gleason score 3+4, Stage IIB. However, there are additional findings of perineural invasion: Present. I preserved one side ...
Dr. Du Shixi Reply:
Hello: You have localized prostate cancer (stage T1-2 N0), which is classified as localized prostate cancer. Your pathology report indicates a Gleason score of 2B. Wishing you good health.[Read More] Understanding Prostate Cancer Staging After Da Vinci Surgery: Key Insights
Post-Prostate Cancer Surgery: Understanding Chylous Drainage and Catheter Duration
Post-prostate cancer surgery Hello, Doctor. I would like to ask: 1. After my father underwent robotic-assisted surgery, why did the drainage tube later have a chylous-like fluid? Is this normal? 2. Also, why did the doctor say that the urinary catheter needs to be in place for 1 ...
Dr. Du Shixi Reply:
Hello: 1. Each surgery may vary depending on the patient's condition, so if you have any doubts, you can consult the surgeon during your follow-up visit. 2. It is not uncommon for a urinary catheter to be in place for two weeks, as the urethral wound requires time to heal. W...[Read More] Post-Prostate Cancer Surgery: Understanding Chylous Drainage and Catheter Duration
Understanding Prostate Cancer Treatment and Diagnostic Options
Treatment of prostate cancer? Hello Doctor, my father was diagnosed with stage IV prostate cancer with bone metastasis in early November last year. His initial PSA level was 256. He is currently receiving monthly injections of Enzalutamide and taking oral medication, which is Bic...
Dr. Li Minghui Reply:
Hello: Please discuss your bone pain issues with your attending physician. Depending on the size of the hospital, it is generally experienced that pain may occur before medication is taken, and pain relief medication may still be needed after treatment. Additionally, health insur...[Read More] Understanding Prostate Cancer Treatment and Diagnostic Options
Managing Advanced Prostate Cancer: Treatment Options and Diagnostic Clarity
Stage IV prostate cancer Hello Doctor, my father was diagnosed with stage IV prostate cancer with bone metastasis in early November last year. His initial PSA level was 256. He is currently receiving monthly injections of Enzalutamide and taking oral medication, which is Bicaluta...
Dr. Du Shixi Reply:
Hello: Please discuss your bone pain issues with your attending physician. Depending on the size of the hospital, it is generally experienced that pain may occur before medication is taken, and pain relief medication may still be needed after treatment. Additionally, health insur...[Read More] Managing Advanced Prostate Cancer: Treatment Options and Diagnostic Clarity
Managing Persistent Elevated PSA Levels After Two Benign Biopsies
If the PSA levels are abnormal and persistently elevated, and two biopsies have confirmed benign results, the next steps in management may include: 1. **Active Surveillance**: Continue monitoring PSA levels and perform regular follow-up exams, including digital rectal exams (DRE...
Dr. Cai Zhuorong Reply:
In addition to PSA and free PSA, the volume of the prostate and the PHI score can also be considered for a comprehensive assessment. Furthermore, whether the MRI conducted in September raises suspicion of potential prostate cancer lesions is also an important reference. Evaluatin...[Read More] Managing Persistent Elevated PSA Levels After Two Benign Biopsies
Combining Radium-223 with Second-Line Hormonal Therapy: Key Considerations
The issue of combining Radium-223 with second-line hormonal therapies? Hello, I have stage IV prostate cancer with bone metastasis and have developed bone pain. My PSA level has exceeded 100, and I am currently awaiting Radium-223 treatment. I would like to inquire about the use ...
Dr. Jian Weihong Reply:
Hello: Based on my understanding, Radium-223 (such as Xofigo) is to be used under specific conditions and cannot be combined with enzalutamide. It is indicated for the treatment of castration-resistant prostate cancer (CRPC) patients who have symptomatic bone metastases and no vi...[Read More] Combining Radium-223 with Second-Line Hormonal Therapy: Key Considerations
Managing Bone Metastasis in Stage IV Prostate Cancer: Treatment Insights
Stage IV prostate cancer with bone metastasis? Hello, I have stage IV prostate cancer with bone metastasis and have developed bone pain. My PSA level has exceeded 100, and I am currently waiting for radium-223 treatment. I would like to inquire about the use of enzalutamide to su...
Dr. Du Shixi Reply:
Hello: Based on my understanding, Radium-223 (such as Xofigo) is restricted for use in the treatment of castration-resistant prostate cancer (CRPC) patients with symptomatic bone metastases and no organ metastases. Patients must meet the following three criteria: 1. The patient m...[Read More] Managing Bone Metastasis in Stage IV Prostate Cancer: Treatment Insights
Understanding High PSA Levels: Risks and Next Steps for Prostate Health
Elevated PSA levels? Hello, Doctor. My father visited a urologist in October due to urinary issues. The doctor diagnosed him with benign prostatic hyperplasia (BPH). However, his PSA level was later tested at 4.8, which is greater than 4. The doctor advised him to take Harnalidge...
Dr. Du Shixi Reply:
Hello: In some cases, levels may decrease, and if urination improves, some individuals may see improvement. A biopsy is merely a sampling procedure, and there is a possibility of complications occurring. Additionally, it is still possible that cancerous tissue may not be sampled,...[Read More] Understanding High PSA Levels: Risks and Next Steps for Prostate Health
Understanding Prostate Hardness: What Does It Mean for Your Health?
There is a hard mass in the prostate? Hello Dr. Lee, my father is 68 years old and in late September, during a health check-up at National Taiwan University Hospital, a hard mass was found in his prostate, and his PSA level was 4.3 (he has symptoms of benign prostatic hyperplasia...
Dr. Li Xinyi Reply:
I understand your concerns, and your thoughts are valid. It is indeed possible to schedule an earlier follow-up appointment to discuss with the doctor.[Read More] Understanding Prostate Hardness: What Does It Mean for Your Health?
Understanding Prostate Issues: What Does a Normal Biopsy Mean?
Prostate issues Hello Doctor, my father is 68 years old. In early October, during a health check-up, a hard mass was found in his prostate, and his PSA level was 4.3 (with symptoms of benign prostatic hyperplasia). At the end of October, the doctor arranged for a biopsy. Today, d...
Dr. Du Shixi Reply:
Hello: A PSA level greater than 4 indicates approximately a 1 in 5 to 1 in 7 chance of cancer. The presence of a lump detected during a physician's digital examination can be subjective, which is why sometimes a physician may feel it, and other times it may not be present; t...[Read More] Understanding Prostate Issues: What Does a Normal Biopsy Mean?
Post-Toilet Abdominal Pain Radiating to Chest: A Urology Concern
Pain in the lower abdomen after urination that radiates to the chest? In 2020, I was diagnosed with prostate cancer and underwent robotic-assisted laparoscopic surgery (Da Vinci surgery). However, after the surgery, I began to experience pain in my lower abdomen after using the r...
Dr. Du Shixi Reply:
Hello: If the urology urine test is normal and urination is smooth, it should not be related to the prostate. It is recommended to consult a cardiologist for a thorough examination. Your issue is quite rare, so try to relax. Wishing you good health.[Read More] Post-Toilet Abdominal Pain Radiating to Chest: A Urology Concern
Understanding Prostate Cancer: Managing Urinary Issues and Hormone Therapy Options
Prostate cancer Hello Doctor, my father had a PSA level of 32.5 and a prostate volume of 45 in September. He underwent a laser enucleation procedure, and the biopsy results confirmed prostate cancer. The doctor arranged for a bone scan and MRI, which showed no bone metastasis or ...
Dr. Li Minghui Reply:
Hello: 1) Postoperative urinary incontinence generally improves gradually over several months. If the amount of leakage decreases, it will continue to improve. Medication can also help, but the extent of recovery may vary. 2) Hormonal therapy is a common treatment option that sup...[Read More] Understanding Prostate Cancer: Managing Urinary Issues and Hormone Therapy Options
Understanding Prostate Cancer: Managing Incontinence and Hormone Therapy Options
Prostate cancer Hello Doctor, my father had a PSA level of 32.5 and a prostate volume of 45, and underwent a laser enucleation procedure in September. The biopsy results confirmed prostate cancer, and the doctor arranged for a bone scan and MRI, which showed no bone metastasis or...
Dr. Li Minghui Reply:
Hello: 1) Postoperative urinary incontinence generally improves gradually over a few months. If the amount of leakage decreases, it will continue to improve. Medication can also help, but the extent of recovery varies. 2) Hormonal therapy is a common treatment option that suppres...[Read More] Understanding Prostate Cancer: Managing Incontinence and Hormone Therapy Options
Managing Prostate Cancer: Addressing Urinary Incontinence and Treatment Options
Prostate cancer Hello Doctor, my father had a PSA level of 32.5 and a prostate volume of 45 in September, and he underwent a laser enucleation procedure. The biopsy results confirmed prostate cancer, and the doctor arranged for a bone scan and MRI, which showed no bone metastasis...
Dr. Li Minghui Reply:
Hello: 1) Postoperative urinary incontinence generally improves gradually over several months. If the amount of leakage decreases, it will continue to improve. Medication can also help, but the extent of recovery may vary. 2) Hormonal therapy is a common treatment option that sup...[Read More] Managing Prostate Cancer: Addressing Urinary Incontinence and Treatment Options
Understanding Prostate Cancer: Managing Urinary Incontinence and Treatment Options
Prostate cancer Hello Doctor, my father had a PSA level of 32.5 and a prostate volume of 45 in September. He underwent a minimally invasive laser enucleation procedure, and the biopsy results confirmed prostate cancer. The doctor arranged for a bone scan and MRI, which showed no ...
Dr. Du Shixi Reply:
Hello: 1) Postoperative urinary incontinence generally improves gradually over several months. If the amount of leakage decreases, it will continue to improve. Medication can also help, but the extent of recovery varies. 2) Hormonal therapy is a common treatment option that suppr...[Read More] Understanding Prostate Cancer: Managing Urinary Incontinence and Treatment Options