"PHILIPPINE MAN HAS PSA TEST DONE.  DOES HE HAVE CANCER?"

“Hello! Doc, busy? My husband Doc. on this coming tuesday he has a check up again. Can I send you a result of his ultra sound? He feel that he has a frostate enlargement but I said to him you need to go to the doctor to make medical check up, then he noticed that he has a milk calcium syst in the left kedney!” (Ms.DD, Philippines)

Dear Ms. DD,

The last time we visited, you had sent your husband’s sonogram report which confirmed a benign, renal milk calcium cyst.  In addition, I mentioned the following statement to you and your husband (Pepe), “since your husband “feel he has frostate enlargement,” I suggest that your husband ask his doctor to perform a digital rectal exam and run a PSA test (prostate specific antigen) test.  The PSA test results provide a snap shot of potential prostate conditions including benign prostatic hypertrophy, and along with a digital rectal exam, this test will help rule out prostate cancer.  We should make sure that the prostate is not evolving into a future, serious problem.”

Subsequent to our discussion three weeks ago, your husband had a PSA test completed, and you forwarded a scanned picture of the result.  Your husband’s PSA result was a 0.435 ng/ml, a value well within the normal range of 4.40 ng/ml.  Since this is your husband’s first prostate blood test completed, we have no previous reference number to gauge whether Pepe’s symptoms mirror the test result found.  However, he should rest peacefully tonight knowing that the 0.435 result, at face value, does not appear to reflect any pathology or condition of his prostate gland.  My recommendation, is to ask that your husband repeat a PSA test one year from today.  When that result is in hand, please contact me, as a means to guide further treatment if needed.

However, if your husband experiences worsening symptoms including 1) frequent urination at night, 2) urgent need to urinate, 3) difficulty urinating, 4) weak urine stream, 5) a urine stream that repeatedly starts and stops, 6) blood in the urine and or 7) the inability to completely empty the bladder during urination, your husband should have the PSA redone in six months with urgent consultation with his doctor or a urologist to include a prompt digital rectal exam.  The symptoms mentioned above could reflect a worsening prostate condition even though today’s PSA blood test result indicates otherwise.

I am deeply humbled by your trust in me.  Although we are miles apart, do know that I care about the health and well-being of all people who inquire medical assistance.  You all are, in essence, my patients; however, my advice is never a substitute for seeking professional medical services from a doctor or health personnel within your locale.

God Bless you, God Bless Pepe, and God Bless the Philippines.

“Always, walk in peace.”

Respectfully,

Dr. Roshin