Advances in Prostate Health

I believe that prostate health one of the reasons men don’t go to the doctor as much as they should.

As you may know, I believe that all men over 40 should get a prostate check and a PSA once a year.

The prostate is a weird gland. It’s located around the urethra, so the only way to feel it is through a rectal exam. You can’t feel every side of the prostate through this exam, but you can feel how large it is and whether or not there are any nodules on it that are suspicious.

Note: Prostate checks also give you a chance to screen for rectal cancer.

It’s an easy test. It’s not painful, but can be uncomfortable.

Lots of men don’t go to the doctor because of this exam, or they simply might defer to the PSA, which is useful in some ways but not a great test.

I’ll explain what I mean when I say it’s “useful”, but not a great test.

I’ve seen guys with prostate cancer with a PSA of 1. I’ve followed guys with a PSA of 18 who had no cancer.

It’s an imperfect test that can be influenced by a number of different things.

Mine has been up to a 5.5, and now it’s at a 2.

The PSA can be influenced by:

• An enlarged prostate
• Inflammation to the prostate
• Recently having sex a day or two before getting the test
• Lifting heavy weights right before the test
• Riding a bike

Note: If you’re coming in for a PSA, do it at least 2 days after sex or lifting heavy weights or riding a bike.

You want to follow the velocity of the PSA more than the number.

Most people say that if you have a PSA of 4 you’re fine. What I look at more is the change in the velocity of the PSA.

A PSA of 1 that goes to 3.5 in one year, for example, would be something that I pay attention to.

Something I tell all of my patients: Don’t get freaked out if you have a PSA of over 4.

Less than one is reassuring of course. But don’t get freaked out.

So, you really need both the PSA and the prostate check.

One of the fears many men have is that they come in for a PSA, it comes back at 4.5 or 5, and they’re going to be sent to a Urologist and they’re going to do a biopsy.

One thing that’s important to know is that there are many options now, and there are differing opinions.

I like the MRI of the prostate. Not a lot of MRI machines in our area have this technology. I have to send them out to Chattanooga, Atlanta, and now I believe UT Hospital has it.

There are a few guys who can do a MRI directed biopsy or an ultrasound guided biopsy.

There’s a lot of advancement in this area!

Note: Free PSA is a good predictor of getting prostate cancer in your lifetime. The higher it is the better off you are.

If you do have a biopsy done, the Gleason score is a measurement of how aggressive the cancer is.

Men often come to me for an unbiased opinion on what to do with known prostate cancer. There are a lot of options and it requires thought and discussion around age, Gleason score, and the size of the prostate.

This is important stuff for men. This is something you need to look at and take seriously, as it kills around 33,000 men a year in the United States.

Keeping a healthy prostate is important.

One thing I can’t emphasize enough is don’t be scared of the prostate. Don’t fear the exam, or the PSA number that comes back.

As men, we’re all most likely going to die with prostate cancer, not from it.

The best thing to do is to regularly get your prostate checked and a PSA.

Stay on top of it so that you can make sound decisions, and look into some of the prevention tips above.