Husband was misdiagnosed

Hi,

To answer your question on an ISO PSA test vs std PSA, the ISO test measures various protein components where a std test just measures the amount of PSA in the blood. Most psa tests look for a trend to see if the PSA is increasing(a sign of possible cancer). A biopsy will detect cancer and also grade it for it’s aggressiveness. Only a biopsy can determine if you have cancer where MRIs and PET scans can pinpoint suspected areas that might contain cancerous growths. BPH can also elevate PSA numbers as does having sex or riding a bicycle before the PSA test. The MRI data can be used to guide the doctor to sample the suspicious areas with greater accuracy. I would think an MRI guided biopsy would be in your husband’s future to determine if he has cancer. Adding extra testosterone I feel is not a good thing since Prostate cancer does feed off of testosterone. One method of slowing down the cancer is to starve it of testosterone called ADT, Androgen deprivation therapy.

Dave 3+4

you are on the rifht track for sure i were the same boat as you 13 years back i had a horrible urologist then I decided to go to a major university ..Stanford ….first things first get MRI if you need a biopsy, I would find a urologist just done thousands of them make sure they do an MRI guided biopsy..dont panic …

Lots and lots of people have BPH but no cancer or cancer but no BPH so I wouldn’t worry too much about the BPH being a sign of cancer.

I am not surprised by the big difference in PSA values taken on the same day. I had two taken the same week and they are different from each other by 20%. It’s a noisy measurement.

The MRI will provide a ton of information. It will identify the size of the prostate, which will allow you to calculate prostate density. It will also potentially identify any lesions, which might suggest prostate cancer.

Hi again,

His new urologist is correct. The 419.5 ng/dL level of testosterone is absolutely normal.

And that makes me to inquire why did your husband to apply for an urological consultation initially. What were the symptoms that took him to the urologist and why such testosterone test was requested.

Has your husband experienced a lack on libido? Feeling constant fatigue or falling into depression showing lack of interest in daily routines?

It is hard to understand that the testosterone test was requested to check for BPH. One would expect a doctor request for a image study to check the size of the prostate gland, or a ecography of the bladder to measure the holding capacity of urine, or even, the dihydrotestosterone that can be a cause for an enlarged prostate gland.

Typically, constant increases of the PSA along the time (even in small amounts) relate to prostate cancer. A graphical representation of the PSA showing ups and dows like the teeths of a saw usually relates to BPH issues.

Well, I would suggest your husband to request the radiologist for providing in his report the size of the gland. Even the wording "enlarged" would satisfy for the investigation on a BPH case.

Best wishes

VG