Recently Answered Questions
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My father is 85-year-old and has been diagnosed with prostatic adenocarcinoma. What could be done?
Query: Hello doctor, My 85-year-old father has been diagnosed with prostatic adenocarcinoma. His biopsy reports show Gleason's grade 3+4 (percentage of grade 4 is 30 %), tumor involves 60 % of submitted biopsy. No perineural invasion is seen. His PSA level is 107.69 ng/mL. He has triple vessel heart diseas... Read Full »
Answer: Hello, Welcome to icliniq.com. You can get a staging workup with PSMA (prostate-specific membrane antigen) scan or bone scan and MRI (magnetic resonance imaging) pelvis. His high PSA (prostate-specific antigen) does make him a high risk but considering his age. I will not suggest a very aggressive a... Read Full »
Why is there an increase in PSA while taking testosterone replacement therapy?
Query: Hi doctor, My prostate-specific antigen (PSA) value has got increased by 30 % from 0.8 ng/mL to 1.1 ng/mL. I am in testosterone replacement therapy also. Please advice. Read Full »
Answer: Hi, Welcome to icliniq.com. The absolute PSA (prostate-specific antigen) level is in the range where it is not of much concern. But the rise in PSA is bothersome if it rises more than 0.75 ng/mL per year. For a young patient like you, even this rise in rate needs to be assessed. Testosterone repla... Read Full »
Please explain my complete health checkup report.
Query: Hi doctor, I am 64 years old. I am nondiabetic. I did a complete health checkup and found my Hb1Ac at 6.5 %. I have a CRP of 3.50 mg/dL. I have PSA at 4.4 ng/mL. My urine culture report shows a negative result. Is there anything abnormal? Please suggest. Read Full »
Answer: Hi, Welcome to icliniq.com. I have gone through the reports (attachment removed to protect patient identity). The most concerning result is about your blood sugar levels. It seems that you can have diabetes. Please consult an endocrinologist for a proper evaluation. Your HbA1c is high, and blood s... Read Full »
Why was Finasteride prescribed despite no urinary symptoms?
Query: Hello doctor, I am a 66-year-old male. My only medical history is hypertension (controlled) with Norvasc. I went for my routine prostate test a couple of months ago and the result stated: 1. PSA - 9.8 ng/mL. 2. Free PSA - 1.9 ng/mL. 3. Percentage free PSA - 19.4 %. I went back to another doctor a f... Read Full »
Answer: Hello, Welcome to icliniq.com. After analysis of the history provided, I would like to give you a brief idea of the same. Firstly PSA (prostate-specific antigen) varies with age. As the age advances, it keeps increasing. Secondly, in spite of that, the PSA level mentioned in your report is in a... Read Full »
I have slow urinating problem with diabetes. Please suggest medication to help both.
Query: Hello doctor, I have a slow urinating problem and I am taking the following medications: Telma H (OD), Glycomet GP (BD), Atorlip 10 (OD), Urimax 0.4 mg (OD), and Vitamin A to Z (OD), and Human Mixtard Insulin 20 units (OD). I have my health check-up done. Please prescribe suitable diabetic and kidne... Read Full »
Dr. Samer Sameer Juma Ali Altawil
Answer: Hi, Welcome to icliniq.com. Prostate enlargement can cause an obstruction and slow urine. After the age of 50 prostate starts to grow to variable sizes. Although size does not matter but the shape of the prostate can cause obstruction. Medications can shrink the prostate up to 30% and cause improv... Read Full »
I have gallbladder issues. What to do?
Query: Hello doctor, I had got an abdomen ultrasound done for other reasons but, the radiologist observed the following 'gallbladder is partially distended and showing few small concretions at the GB neck. Chronic patient of the prostate. Size 47 by 41 by 38 mm, volume 39 cc. Pre-void urine 281 cc, post v... Read Full »
Answer: Hello, Welcome to icliniq.com. How old are you? There is no need to worry. Small concretions are commonly found in the gallbladder. Also, the prostate size is enlarged and it is probably due to a benign prostatic hypertrophy. You should get Serum PSA (prostate-specific antigen) levels done, whi... Read Full »
My PSA is 5.7 and MRI negative. Should I get prostate biopsy?
Query: Hello doctor, I had a 4.4 PSA and had an MRI that was negative. Six months later my PSA is 5.7 and even though the MRI was negative it is suggested that I should have a prostate biopsy. I am a 73-year-old male. I am certainly not that excited to have a biopsy. Any thoughts? Read Full »
Answer: Hi, Welcome to icliniq.com. I can understand your concern about undergoing an invasive investigation without any symptoms. Let me explain you what does PSA suggest. Basically, PSA is secreted by the prostate as well as some other body tissues. It does not reach circulation and hence remains low in... Read Full »
What are the non-invasive procedures to detect prostate cancer?
Query: Hello doctor, I am a 79 year old male. Excellent health, take no medications with the exception of an occasional Viagra. In a recent DRE, my urologist discovered two small nodules on my prostate. A PSA at the time was 6.3. Over the years, I have ranged in 2's and 3's. He suggested a biopsy of the pr... Read Full »
Answer: Hi, Welcome to icliniq.com.I have gone through your query. I concur with your urologist in the need for a biopsy. Any PSA (prostate-specific antigen) more than 4 or abnormal findings on DRE (digital rectal examination) needs evaluation to rule out prostate cancer. None of the non-invasive techniques... Read Full »
Can PAP test alone be valid for screening prostatitis?
Query: Hi doctor, I asked my doctor to do PSA test. The PSA came back normal at 1.0 ng/mL. However, he also did prostatic acid phosphatase test which was high at 4.5 ng/mL. My question is whether prostatic acid phosphatase test is valid for screening or not? Should I need to do these tests again? I had pro... Read Full »
Answer: Hi, Welcome to icliniq.com. I have gone through your query. Prostatic acid phosphatase (PAP) has been replaced by PSA (prostate-specific antigen test). It is better in the detection of prostate cancer compared to PAP. The elevation of PAP levels alone is not a cause for concern. I hope your treating... Read Full »
Why my leukocytes remain high after PSA spike?
Query: Hi doctor, Recently, I had a very high PSA spike. Antibiotics were given for a UTI, although in the end, the culture was negative. Nonetheless, all returned to normal. Antibiotics ceased a couple of weeks ago. Everything normal except now a reading of leukocyte esterase at 25 wbc/Ul (rechecked next ... Read Full »
Answer: Hi,Welcome to icliniq.com.I have gone through your query and the urinalysis report (attachment removed to protect patient identity). You have had an attack of prostatitis, which has led to the very high level of PSA (prostate-specific antigen), and had been subsequently treated with antibiotics. I w... Read Full »