DEAR DR. GOTT:
My husband is 73-years-old and had a biopsy of his prostate because his lab value was 6.2. We were told he had cancer, but were told not to worry. A few days later he came down with a severe urinary infection that put him in the hospital for four days. A few months later his PSA was 1.2 and now it is 1.7. The doctor wanted to do surgery but we said no. Now he wants to do another biopsy. I don’t want to put my husband through this again. Options are seeds, radiation and more that did not interest us at all. We chose to wait.
DEAR READER:
Normal prostatic specific antigen (PSA) readings are from 0-4. Your husband’s reading was high. Having said that, prostate cancer affects about one in six men in the United States and the incidence increases with age.
Prostatitis is inflammation of the gland. Forms of the condition are either bacterial, non-bacterial, or inflammatory. Any organism that can cause a urinary tract infection can also cause acute bacterial prostatitis. Trauma, obstruction, catheterization, cystoscopy or infection in another part of the body can result in bacterial prostatitis. So, your husband’s hospitalization could have come from a number of sources.
Armed with the elevated reading, your husband’s advanced age and the urinary tract infection, the surgeon was obviously leaning toward cancer. That was probably why he chose to perform the biopsy and recommended surgery. He was acting on the side of caution.
To be on the safe side, return to your husband’s primary care physician and request a referral to another urologist for a second opinion. If he or she feels the first urologist acted appropriately, you and your husband then have a decision to make. Does he want to undergo another biopsy? Is there pain involved? Is surgery safe at his age? You have a number of questions that need answering. Sit down for a frank discussion. You will then be in a better position to make an educated decision.
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