Men's Health Matters
Baltimore's Dr. Edward Leventhal gives you advice on how men can live healthier lives.My biopsy results are….
Sorry I have been inactive for so long but Passover and business issues kept me from working on the blog. I realize it’s a bad excuse, but it is the only one I have and hopefully one you will accept.
First lets cover the Ravens draft. While I was hoping for a receiver to show up on draft day, I was very satisfied with the work done by The Wizard of Oz, Eric DeCosta and the rest of the gang at 1 Winning Drive. We needed a long term solution at right tackle and got it in Michael Oher who not only can play, but is a great human interest story. Paul Kruger, our second round pick, reminds me of a young Michael McCrary. Hopefully he will do so on the field. The rest of the draft filled needs with Ravens type ball players. Once again, Ozzie has proven why he is one of the top GM’s in the business. Hopefully the NFL will fail to notice DeCosta for a long time, because I think he is a large part of the process.
Now onto the results of the biopsy.
Today is going to be easy. Your biopsy that caused so much heartache when we discussed it oh so many weeks ago has come out benign. That means not cancerous. Typically, I have a patient come in to discuss biopsy results. I really hate giving bad news over the phone. I think it is very impersonal and I would not want to receive a cancer diagnosis that way. So everyone benign and malignant comes in for the news.
Often the biopsy is purely benign. In other words, there are no other findings. In this case, I will tell the patient that he should come back in six months for another PSA and rectal exam. After a benign biopsy, I will see a patient every 6 months for about 18 months to get some more PSA data points for each patient’s PSA graph. That way we will know if, “the trend is your friend.” If the PSA remains steady very often I will just follow the PSA. If the trend is upwards, I will often recommend a repeat biopsy. There was a study done at University of Michigan that showed that the likelihood of missing a significant prostate cancer with one set of random biopsies is 20 - 25%. This drops to about 4 - 5% with a second set of biopsies. Hence my willingness to recommend repeat biopsies.
Often the biopsy will show evidence of acute or chronic inflammation or both. This in and of itself, is enough to raise PSA. For this person, I will often recommend an extended course of antibiotics. This will often run 4 - 6 weeks and afterward a PSA will be obtained. I would like to see the PSA be driven down by antibiotic treatment. It makes me feel a whole lot better about the histologic findings of inflammation being the cause of the PSA elevation.
Occasionally, the results will show atypia or something call PIN which stands for Prostatic Intraepithelial Neoplasia. Neither of these are cancer but both can be harbingers of cancer. Typically recommended is repeat biopsy or close followup of the PSA.
Finally, for the avant-garde guy who wants to be proactive about his prostate health, I will often recommend dietary changes or nutritional supplements to promote the growth of healthy prostate tissues. Soy isoflavins, tomato lycopene, selenium, Vitamin D and E, Fish Oil are all compounds that have been purported to aid in prostate health. My feeling is that they can’t hurt you (as long as done in moderation) and that they may well help you. I consider these type of treatments investments in your health. You benefit by doing it, but I don’t think you are hurting yourself if you defer.
That’s it for today. I am working on the later discussions which will be all about your diagnosis if your biopsy is G-d forbid positive for prostate cancer. Until then, enjoy the spring, plant your tomatoes to get your tomato lycopene, and wait for Ravens Camp to start.
Posted by .(JavaScript must be enabled to view this email address) on 05/03/09 at 08:57 AM | Comments (0)