Urology/Psa

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Question
Hi Doctor,
I had written to you recently about my Psa rising to 7.1 from 1.2  in a year and then within a week to over 24. My urologist said it was infection and not prostrate cancer. You also thought it was caused by Prostittis.
My Psa has now dropped to 3.3.
Is this a positive indication that it is not prostrate cancer ?
I stil have a burning sensation in the penis for long periods even without urination.
I am still taking the cipro  ( 5 weeks )and Advil with the Prostanew supplement. Would you recommend anything else.
Many thanks for your help.

Answer
Rick:

Yes, the fact that the PSa rise was so quick and has returned to a normal level is an indication that it was not due to prostate cancer.

The prostatitis is probably still not completely resolved.

See below treatments for prostatitis.

Brief Summary of Treatments for Prostatitis:

Avoid caffeine, high potassium foods and hot spices which can irritate the prostate and bladder lining.
Hot sitz baths.  Sitting in a very hot tub for 10 minutes really seems to significantly reduce pelvic pain, inflammation and discomfort.  We recommend twice or even three times a day for severe cases or flare-ups, but at least once a day for most prostatitis patients.  Of all the remedies listed here, this is the one with the greatest effect on overall improvement of prostatitis symptoms.
Avoid sitting on hard surface; use an inflatable donut (filled only half way) to divert the pressure away from the prostate towards the pelvic bones where it belongs.  You may also use a gel sitting pad similar to what is used for patients in wheelchairs to minimize pressure on the lower pelvis.
Use NSAIDs like ibuprofen (Motrin, Advil) or naprosyn (Aleve) regularly on a daily basis, unless instructed otherwise by your physician, to help reduce pelvic discomfort, pain and inflammation.   Amitriptyline can also help with pain and pelvic discomfort but is not anti-inflammatory.
Take any antibiotics as prescribed by your physician.  Typically, at least 4-6 weeks minimum is recommended.
Alpha blocker medications such as tamsulosin (Flomax) and alfuzosin (Uroxatral) will help relax muscle tension in the prostate, promote healing and improve urinary flow.
Finasteride or dutasteride may be prescribed to help shrink prostate tissue.  
Elmiron can be used to help protect the lining of the lower urinary tract from the irritating chemicals in the urine.
Burning on urination can be relieved with Pyridium, a medication that makes the urine bright orange,  and an OTC product called Prelief, available without a prescription, that makes the urine less irritating.
Reduce alcohol intake and stop smoking.
Consider using a prostate herbal product that contains Quercetin (found in many prostate supplements like Prosta-Q and Cysta-Q available on Amazon or directly from Farr Labs at www.farrlabs.com) which is a natural anti-inflammatory herbal ingredient that has actually been shown in independent tests to help reduce prostatic inflammation.  The highest rated combination product, according to the “Prostate Health Journal”, is “Prostanew” from BioProsper Labs in Indiana which can also be ordered on Amazon.

Urology

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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 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved 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. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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