What is Elevated PSA and how Advanced treats it

[@connoroleary591]

Clear and informative. As good as 10 minutes alone with a top rated urologist. Thank you.

[@MrMomo2022]

This Dr. has the best explanation, fluently straight to the point, no side tracking like some others.

[@ludegardobenito2880]

my doctor told me to need biopsy base only to results of my PSA that is 9.48.so doctor told me if you don't want we need to untrasound

[@BMT-by5ve]

Awesome explanation. Better than my urologist who seems in a hurry to get me out of the office.

[@shaukatmehmood5643]

A true professional, bless you brother....

[@philbasa6]

Very good Dr that's what my Urologist did I will see him tomorrow I already got a Pet scan at Lenox Hill Radiology in Manhattan

[@misc5831]

I want you to be my urologist I think you're absolutely amazing!

[@michaelrobinson4677]

Absolutely the best explanation out there! I just came back from prostate biopsy. Next week , results. I can handle anything, but the way to you presented it makes sense! Thank you!

[@livelovedaydream]

How was it?

[@garywanner7860]

Thank you Dr for this great video! I’m 68, and my Dr has me doing PSA tests every 6 months because of erratic results.

[@Little_Sprite95]

Thank you for explaining it so well! This made a scary situation a lot easier to understand and made me feel much calmer!

[@mikesnyder1788]

Excellent presentation! I have recently walked down this road and all the signposts look very familiar. Best to you all as you deal with elevated PSA! Kind regards!!!

[@acmm50]

The most thorough explanation of prostate issues and treatments I have heard to date. Thank You Dr I wish you were my Urologist

[@theketovorian]

Great information that answers so many of my questions. Should have 1M views by now!

[@stephenpisani1730]

Im 65yrs old and for the last 14 months my psa is 12.4. My Urologist has sent me for MRI scan. Result came back as inflammation and enlarged prostrate. My Urologist said i have prostatitis which is the reason for high psa level. He said their is no showing of cancer on the mri scan. Im a little nervous as my Dad and Grandad both passed away with prostrate cancer. I had another psa blood test this morning and praying its come down. It will take a week for blood results.

[@pdaniaful]

Hope your result came back negative. My PSA was 15 when I did my first MRI followed by a biopsy in 2019, biopsy came back negative and they diagnosed Prostatitis, since then I've been having blood tests for PSA, the figures are up and down, highest was 30 in January 2023, then it came down to 20 and the last time which was December last year, it was 27.3 I have burning pains in my perineum sometimes, if I'm stressed or I've been sitting for a long time. Since 2019, I've had a total of 3 MRI scans which have all come back negative The consultant wants to do a Prostate massage under GA for me on Friday next week but I'm still very skeptical, too much poking around there. My biopsy, they took 33 - 35 cores and I had urine retention and had to use a catheter for 10 days. If I'm honest, I've had worse symptoms before since my biopsy.

[@stephenpisani1730]

@@pdaniaful Yes if have prostatitis psa levels will go up. I had psa blood test 5wks ago and it's come down to 9. I took another MRI scan 3wks ago and seen Radiologist since with results and he reassured me their is nothing cancerous showing all clear except slight inflammation which is the cause of prostatitis. I'm taking Omnic 0,4 capsules for the prostrate which helps the prostrate to relax and less visits to the toilet at night, maybe one visit. I've avoided biopsies as sticking needles into an already inflamed prostrate ain't going to help.. I'll take an MRI each year to keep a check on the situation. I hope all works out for you.

[@charlesblumenstock9160]

Getting trus as favor for Dr. And me

[@joeviede4586]

Thank you for your explanation Dr. It so happens that as early as yesterday i went into theatre for a cystoscopy and biopsy of my prostrate. Now experiencing the post op situations.. blood, pain, etc etc. . My results expected in 2-3 days. Holding thumbs. Thank you once again.

[@viprakamy8568]

Thank you Doctor . Very well explained !

[@ddadds3152]

Thanks, Doc. Please explain to your listeners that the biopsy procedure you reference ( 6 needles on either side of the gland) samples only about 1% of the gland, which is normally walnut shaped. Moreover, in the absence of any foci that might be detected on Prostate specific MRI, the biopsy can easily be described as random, correct? In other words, if the needles don't sample an area or areas (foci) where scans have shown the likelihood of an increased concentration of possibly infected tissue or cells, the biopsy is essentially a blind procedure. Randomly sampling 1% of a small gland arbitrarily, given the increased risks for post procedure complications, then seems suspect, doesn't it? In the presence of early elevated PSA values and/or any of the other signs/symptoms you reference, why aren't Prostate Specific MRIs or other newly emerging, more precise imaging modalities not an automatic before moving on to biopsy? I understand that the high costs associated with those tests might be prohibitive. But doesn't it seem overwhelmingly obvious that these scans be included in the Standard of Care discussion surrounding Prostate Cancer early screening, comprehensive exam and diagnostic work-up? Thank you again for your expertise in helping to educate us 50yo+ men who have been or currently are facing this conundrum of possible over diagnosis and/or over treatment once a slight elevation or slowly increasing PSA number over time, in the absence of most of the other signs/symptoms, has become evident after physical examination.

[@Usefulmusic]

"...possible over-diagnosis and/or over-treatment...". Luckily I live in a country where there is no financial incentive to prescribe treatments that are not strictly needed.

[@archiebunker7688]

I have heard that biopsies can be targeted to apex lesions with imaging either mri or sonogram? I've had 2 biopsies through rectum and suffered a uti with the last and it was quite a painful experience for a week or so til antibiotics got a grip. I understand a new biopsy procedure has the needle traveling through the scrotum and eliminate about all infection risks.

[@RealRocdad]

I made the same argument to my urologist and he did attempt to get me a PSM a pet scan first, Insurance said no

[@jimschaefer9858]

P pm

[@lambertvillaroel7708]

best best explanations I ever encounter ..now I am educated.. YOU THE BEST EVER...

[@stanwhite2579]

Wow! Answered all of the questions I had regarding the prostate, tests, options, etc. What a gift you have, doctor. Thank you!

[@weldonhogan9259]

Knowledge is power! Thank you, I feel comfort in knowing how the process to make a determination works.

[@paulmaxwell8851]

A great, straight-forward plain-language talk! Excellent!

[@michaelg.9351]

Thank you, Doctor. This was a thorough and honest explanation.

[@johnnysalazar3951]

A very honest Doctor. Thank you

[@rakeshdalal]

My dad is 100 years old & PSA level jump from 30 to 40. Doctor recommended immunotherapy for prostate cancer but avoided biopsy and MRI for prostate cancer confirmation. He seems sure with his experience to go this way. What you think ?

[@privatepenguin3137]

Excellent overview and timeline background. My PSA came in at 3.76...so I need to see a urologist. My appointment is in 3 weeks, so this helped me understand what to expect. Thanks!

[@sirtarquin928]

I need a biopsy my PSA is 15

[@Troyboy2121]

Under 4.0 and a Urology referral?

[@privatepenguin3137]

@@Troyboy2121 It was always about 2.5...then a year ago...rose to about 3.7-3.8 for the last few blood tests...that is why they sent me. The urologist sent me for an MRI which came back clean....now in the past few weeks, I tested at 6.5. I need to go for another blood test next week...if that hasn't improved to under 4....it will mean another MRI.

[@jimsnellen6222]

Thank you very much. I’ve been referred to a urologist for a very high PSA. Your presentation removed some of my worries.

[@burhan067]

How much was ur psa and what happened

[@jimsnellen6222]

@@burhan067 15. Retested at 1.7!

[@burhan067]

@@jimsnellen6222what made it lower so much?

[@mariadempsey1619]

Thanks so much Dr. Greenstein, very informative.

[@jcolumbiap]

Thank you! This sounds like doctors that are also scientist!

[@simplemann556]

Thank you for the explanation, unfortunately my PSA score was a concern (I"m 62) so I'll be going to a urologist in the near future. Good luck to everyone, aging is a battle and you need to be prepared to fight.

[@darrylpetersen20]

This has been very helpful in preparing for my biopsy...

[@robertosso5210]

im 58 and i just found out my psa is 1.5 which my doctor said is perfect

[@billyjohnson9166]

I got a deadly infection from a biopsy that I’ve been fighting for nine months to get rid of. I’ve been on antibiotics most of that time. I’ve been in the hospital multiple times on antibiotic drip one time for three weeks three times a day. I’m desperate for help.

[@pmh1nic]

Very informative video. For me it started as a year by year elevation of PSA from mid 4 to mid 5 to mid 6 then a jump to 10 in a matter of three months. That was a sign it was time for a biopsy which was positive for cancer. Fortunately it was identified early, not super aggressive and there is a high confidence that it's confined to the prostate (bone scan to confirm). Cryoabation (sp) will be done to deal with the cancer and hopefully it will be successful.

[@glenm5034]

My Urologist never recommended a PSA test but wants me to have a prostate biopsy.Time to look for a new urologist

[@ricknovick4777]

It doesn't sound like your urologist is Board Certified. Always look for doctors who have achieved Board Certification. It isn't awarded automatically by the American Board of Urology to every doctor who has completed a residency in urology. There are additional testing requirements after that. If all steps are completed successfully, the doctor will become a Diplomate of the American Board of Urology.

[@berg6964]

Great information! Thank you Sir

[@RafaelCruz-iv2wm]

the best explanation i ever heard. thanks Dr.

[@willisgoodger1875]

Thank you for the information and procedure. Very helpful.

[@youcandoitjr2031]

Excellent video. Great doctor. Where is this doctor located?

[@alaplex100]

Great explanation. Just wished he would have elaborated more on velocity. In 2011 my.psa bounced from 5.53 to 4.76. Then in 2013 back to 5.53. Then in 2022 it went to 8.6. I know velocity and how long it takes to double in value is an important factor.

[@jagosingh85]

Wow! Superb explanation. 🙏🏻

[@NaturalMeAmerica]

The first time I went to a urologist in PA, he did not do any blood or urine tests.He only showed me some walnuts and vompare different ones to my prostate size

[@mateslami]

The urologist that I saw didn't do any of the above. After the PSA test which was 4.8, he sent me for the biopsy, knowing that I have an enlarged prostate! The biopsy was negative which means he put me through months of worry and pain.

[@jerryholmes9999]

Where are you located? I need a doctor like you. My urologist only wants an immediate 12 needle transrectal biopsy, no discussion just let’s go do it. Asked about a trasparanial biopsy, no he says, I only do one type of always do it that way, no insurance isssues just accept it.

[@vipwise1129]

Very good information much appreciate it

[@zman5970]

Very informative.. thank you..makes me feel more positive 😊

[@jovitarich7078]

From a concerned ex wife who loves her ex, thank you so much!!!

[@jerrystanley6820]

I been showing protien in urine for 30 years but only recently had PSA test of 5 seen urologist 30 years ago finally told well some men just have some protien

[@KerryBoehm-o2e]

Thank you, very clear explanation.

[@rico2207]

Good Job Doc..Helps

[@jamestyrer6067]

Thanks for this very well explained video

[@live2encourage]

Excellent video. Thanks. Question: if there is cancer in the prostate, will a man's PSA steadily rise? Could it still go up and then drop, go up and then down?

[@jitendranathjohari8582]

If the tests suggested are displayed on the screen,it would be helpful to the viewers

[@janetw9430]

Good explanation of PSA density. My husband has a density of 0.016, his doctor told us he has prostate cancer and needs a TRUS biopsy. His urologist says we just do PSA tests and MRI imaging.

[@cooperroscatman3394]

Density of 0.016 is VERY LOW RISK. Are you sure you typed correctly. Even if it were 0.16 that by itself is almost meaningless. What was his PSA?. Here in major NY hospital centers they would recommend a mpMRI (multi-parametric MRI) of the Prostate before doing a biopsy. If the MRI result is PIRADS 1 or 2 and PSA is under 7.0 then NO BIOPSY - just active surveillance. Also if a biopsy is needed consider a transperineal prostate biopsy not a Trans Rectal which has a higher infection risk.

[@janetw9430]

@cooperroscatman3394 0.016 is his density. I double checked his MRI, he has BPH.

[@janetw9430]

@@cooperroscatman3394 , I double checked his MRI report, his density is 0.016 and they do not do mpMRI here. He gets his PSA done every 6 months and yearly MRI. His PI-RAD score was 3, possible due to BPH??? He has refused the blind 12 + core TRUS biopsy.

[@anthonygasparini1734]

Excellent video thank you!

[@강경화-j8s]

MRI is better for targeted biopsy

[@joseapadilla1484]

Good to know. However, if your psa goes higher it’s necessary right away to conduct a biopsy, or conduct a MRI?🤔 Thank you.

[@brianshannon3071]

Very informative

[@claudioluna7299]

Thank you for the very clear explanation of what I am about to go through!! 😊

[@georginamuns44]

Excellent explanation Dr. ! my brother just had his third PSA result and it has been going up from 4 to 6.49 to 8.08.. do you have a urologist you highly recommend in the Miami, or Miami Beach area? He hasn’t had any MRI, nor biopsy yet. He is 64 years old. I am worried … can you please help? Thank you so much and many blessings. Georgina

[@MoayedAlSalman]

hi I need your second opinion about my situation with prostate cancer that I am dealing with for 3 years now.. it started when I had a very bad back pain on the left side to be accurate I thought it was a kidney stone after the ultrasound the ct scan and the other check and finally a blood test and biopsy they found out that my PSA was 274 and I was diagnosed with prostate cancer metasis to the bones. I was on pills for more than a year and lupron shot and still on it after a year and a half the pills start not working and my PSA was going up my pills was changed & again the other pill didn't work I did 3 times radiation of course with the pain that I had with my bones, they did a genetic test it was from my both sides, I did chemo for 5 times did a big damage on my nerves stoped and then I was on pills again for 6 months only and now ia m back on chemo again this is my fifth one and my PSA was 7 went up to 12 & 17.2 & now 20.3 please give me your opinion I would appreciated

[@anthonyshaw8698]

Excellent video!! 👍🎩👍

[@robshaw3655]

Thankyou for such a good explanation. In uk the procedure ive been told and part way through ..raised psa found when i asked them to check when taking bloods for another matter, followed by a DRE, followed by MRI and the outcome of that will be a biopsy or not. If no cancer found do they suggest medication for non cancer raised psa or just wait see and test blood again in future?

[@kellyclover5953]

I hope you have good information on what to do with BPH that's causing pain, not just frequent bathroom trips in the total absence of elevated PSA. With calcium deposits being found in the prostate. Also what would you do with polycystic kidney disease caused by a faulty IFT 140 gene? There is no evidence of cancer in any of the cysts but some are very large. What would you do with a 3 mm calcium stone in the lower pole of a kidney with no apparent symptoms?

[@colinshaw3326]

Most doctors, don't want you to bother them, they merely say theirs risks in living, ask for tests , and they say it'll cost you,expensive if unnecessary, but you be the best judge.

[@joycekoch5746]

As a mother of two boys is there anything as too diet or other things that I can do so my guys don't have prostate problems later in life?

[@connoroleary591]

No. Just focus on a healthy diet, rich in vegetables, fruits, salads and fish. And encourage them not to smoke or drink to excess.

[@randypleva2397]

I’ve been putting it off for years , my PSA is 17 drops to 12 then back up .

[@iantheedey9455]

Great video!!

[@juliusnjau2537]

I am just ask you a doctor check and Find it my. prostate. swelling. Can you tell me why thank you

[@da7heaven]

very few doctors are doing DRE anymore. I hope that's not increasing patient risks.

[@charlesblumenstock9160]

I agree it a rarity

[@charlesblumenstock9160]

Yes I did mention that I have not had a dre in years he took the hint yes I got exam and a refferel to a urologist for another dre and a possible ultrasound so yes it's a rarity not for me anymore should have not mention now its😂

[@PaulNugent-t2r]

What the doctor ment when he said the psa reaches 700

[@Samprasad12]

Thanks very valuable

[@estelamino6356]

THANKS for sharing.

[@taiwoomoyeni4023]

Feeling back pain, painful urination and headache for more than 3 years, can it be prostate cancer or what

[@dimitrioskazis7989]

What is your opinion if the PSA level is around 13 and the previous values were 10 and 11.5 over a period of 6 months difference. With an elevated BPH of 60 c.c. volume and small sudden signs of blood in the urine early in the morning, will an MRI be imperative with a prior Ultra sound view of the prostate ? is this the satisfactory check for prostate cancer in its early stages ? Thanks for the video clip, very informative indeed.

[@papavaliquette4978]

Thank you doc!!

[@tarekolya9457]

What about prostrate cancer prevention, do you have some advices

[@gvet47]

At 75 mine was 86 and later with cancer spread it was tested at 5000! Bad thing are hapening.

[@silvanotonini9151]

I've been there and you're well and truly in the shit.

[@tapaskumarchoudhuri8612]

Good morning Doctor. My PSA is 7.54 What is your advice. Thanks🙏

[@billyjohnson9166]

You need a biopsy

[@johnston378]

thank you

[@RealRocdad]

66 years old, first PSA > 600, month later 900, CT shows enlarged prostate schedule for 3t MRI before needle biopsy... The worst part is I'm almost symptom-free but I feel like everybody's telling me I'm a walking dead man.

[@burhan067]

So what’s going on? What did the biopsy say?

[@RealRocdad]

@@burhan067 Gleason 7 most of right side, expect metastastic going for PSMA PET, too late for surgery, too late for radiation, probably too late for ADT. Doctor suspects they'll want to use only chemo...

[@burhan067]

@@RealRocdad good luck to you man , hopefully things get better. My dad had a psa done it came out as >100, Dk the exact value but i feel like my whole world is falling apart. But i’ve heard some doctors say it could be because of utis or prostatitis

[@RealRocdad]

@@burhan067 just remember the best medicine is Hope. If you really want to help him make sure he has a good healthy diet no processed foods.

[@burhan067]

@@RealRocdad yeah. He’s around 50, not even that old and he had an extremely severe uti, i’ve seen online people saying utis affect psa. So maybe that was the case, I’m just clinging to hope

[@peterfardell9267]

Nice video thanks, but the title is a misnomer - you don't actually TREAT anything. I want to see the options and relative (statistical) effectiveness of treatment for the various grades of prostate cancer if needed after your initial diagnosis (which is what this video is about) - e.g. Radical prostatectomy, Holep, Turp, and/or combined with Rapid Arc radiotherapy, androgen deprivation therapy (and associated testosterone recovery periods). That would make a gold standard video.

[@Reggie2699]

Thank you!

[@whitewolf4016]

Well done

[@daverdal1]

doesn't sound that bad, thanks!

[@charlesblumenstock9160]

My doctor gave me a order for a trus test this will give Dr. info on prostate size select MD is also good MRI is😎 4:50 4:50 4:50

[@dkilroy905]

The new perineal prostate targeted biopsy has fewer infections.

[@mendesnelson]

Well explained!

[@LauraIchozki]

what might cause a 49 year old healthy male's PSA to go from 1 to 3 within 12 months?

[@cashmiller2999]

Hi any news? Mine was 1.2 in December and just tested 3. More than doubled in 9 months 😢

[@craftrunner]

Hi Fantastic information video, answered a lot of worry for me. I have just had a prostrate examination the doctor has said that its enlarged and not smooth with a hard centre. I have now had a blood test which came back with a PSA of 518. He has referred me to a urologist. Is it possible to have a number that high I am 72years old Kind regards

[@misc5831]

What about blood in semen and a high PSA?

[@hhrfc671]

Thanks

[@askgodforyou]

Does psa 1.1 to 1.5 elevated in one year a concern thank you

[@charlesblumenstock9160]

The psa can come down with tomato's and greentea

[@jeffcarmack1914]

I’m 48 years old and my blood work came back saying my psa is 122😢 I’m so worried

[@billyjohnson9166]

I’d be very worried. You need a biopsy

[@jeffcarmack1914]

@@billyjohnson9166 biopsy coming up!

[@billyjohnson9166]

@@jeffcarmack1914 good luck I got a biopsy in the Philippines where I live and got a deadly infection I can’t get rid of. I’ve been in the hospital three times 7, 16, and 21 days getting antibiotic drip around the clock. I almost died once. Went into sepsis shock. Sorry I’m not trying to scare you.

[@jeffcarmack1914]

@@billyjohnson9166 I pray for you but I’m not scared to die I got god but I’m not ready too. Hope your ok buddy!

[@billyjohnson9166]

@@jeffcarmack1914 thank you so much. I’m going back to the U S on the 30th for another opinion on treatment from a U S doctor

[@mskdnejwuibwiunsgertrhjdhrudke]

what he doent tell you is he cant biopsy the whole prostate so he can miss cancer also if you get an infection it could kill you

[@RogerSlick]

🤔 Excessive ejactulations also increase PSA levels

[@davecooke7868]

My PSA was 9 , is that bad?

[@alliaj1]

can be .....

[@melchizedek1552]

A nice level-headed gentleman

[@muharremsekmen8762]

Muharrem(mhrs

[@charlesblumenstock9160]

Biopsy is not a fun test numbing is slitely painfull 7:26

[@alcoury332]

Where are you located

[@Hanover-ek4jy]

Atlanta!

[@juliusnjau2537]

Japan

[@juliusnjau2537]

Japan