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About Stephen W. Leslie, MD
Expertise
Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience
Full time practicing urologist with 20 years experience. Assistant Clinical Professor of Urology at the Medical College of Ohio. Editor in Chief of eMedicine Urology internet textbook. Author of only book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison

Awards and Honors
Thirlby Award of the American Urological Association.

You are here: Experts > Health/Fitness > Urology > Urology > Prostate Cancer with Enlarged prostate

Urology - Prostate Cancer with Enlarged prostate

Expert: Stephen W. Leslie, MD - 11/5/2009

Question
Dr. Leslie, Re: Your answer to me on 07/16/09.
I mentioned that I was beginning to experience pressure between my scrotum and anus in the area where my prostate lies. That "pressure" is now elevating to a slightly irritating throb and occurs virtually all throughout the day most notably when I sit or lay in bed. But it can also occur when I am standing. And I think it is only going to get worse. My last PSA in August at 5.5 was virtually the same as it was in May at 5.4. I was last examined by my urologist with a DRE in September following the August PSA test and I mentioned the growing concern with this throb. When asked by him, I did not feel any pain with the DRE and so the issue was dismissed as probably not a problem.
Q1.) Considering that I do have prostate cancer and that as of August my PSA seems to be stable,
        can prostate cancer grow or spread without a corresponding increase in PSA?
Q2.) I understand that pelvic pain is another sympton of prostate cancer perhaps spreading
       beyond the prostate. Could what I am experiencing between my scrotum and anus be
       considered pelvic pain and therefore might be cancer growth?

Answer
Prostate cancer can grow without an increase of PSA but this would be extremely unusual as we generally use the PSA level to determine the extent or growth of any prostate cancer.

Pelvic pain can also be due to many other problems such as side effects of prostate cancer treatment. The area between the scrotum and anus is directly below the prostate and therefore this is an issue. If the prostate is not directly involved per your urologist, a trial of ibuprofen and hot sitz baths might help.

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