I am taking proscar daily. I have not had prostate cancer. I am 70 yo. I just had a yearly PSA test and my PSA went from 1.1 to 1.3. My urologist wants to schedule me for a biopsy. He says that if I am taking proscar my PSA should never rise at all. I dont think the rise is that significant. Can I please have your opinion? Thank you. PS I came to you at UVA for a second opinion on my prostate PSA problem about 10 years ago.

First, I am glad you continue to do well ten years after your visit. Before I would recommend a biopsy in this situation, I would want additional indicators of a problem. Patients without cancer can still have a PSA that varies month to month by more than the 1.1 to 1.3 ng/ml you mention. Rather than a one-time increase in this range, I would be more concerned by an increasing trend. For example, if the PSA has gone 1.0, 1.1, 1.2, 1.5, I would then think transrectal ultrasound. I would also look for a change in the size or texture of the gland by digital rectal exam. If your PSA was higher, we could use the total and %free PSA – a dropping %free PSA would be an indication for biopsy. Perhaps, your urologist has noted something that triggered his concern and he has failed to mention this to you?

Ask Dr. Espinosa

Geo Espinosa, N.D., L.Ac, CNS, RH (AHG) is the Director of the Integrative Urological Center at New York University Langone Medical Center. Before joining NYU, Dr. Espinosa was a clinician, researcher and director of clinical trials at the Center for Holistic Urology at Columbia University Medical Center. He is a licensed naturopathic doctor, licensed acupuncturist, a Certified Nutrition Specialist and a Registered Herbalist. Dr. Espinosa is an author of the naturopathic entry in 1000 Cures for 200 ailments, by Harper Collins; March 2007 and “Prostate cancer – Nutrients that may slow its progression,” Food and Nutrients in Disease Management - Maryland: Cadmus Publishing, 2009.

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Medical oncologist and prostate cancer survivor, Dr Charles "Snuffy" Myers was a key player in creating AZT, Suranim, and Phenylacetate while working at the National Institute of Health. With over 250 research papers published, Myers is one of the leading developers of today's prostate cancer canon on both the research and treatment side of the test tube. Former Cancer Director at the University of Virginia, Myers opened the American Institute for Diseases of the Prostate in 2002 to provide men with the kind of comprehensive care that saved his own life. Dr. Myers has long been popular among prostate cancer patients as a speaker because of his ability to explain science and medicine in easy-to-understand language.

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Dr. Latini welcomes your questions about the psycho-social dimensions of Prostate Cancer, particularly those presented by Gay and Bisexual men. Dr. Latini is an assistant professor of urology at Baylor College of Medicine. Before joining Baylor, he spent six years in the Department of Urology at the University of California, San Francisco. Dr. Latini is a clinical health psychologist whose work concentrates on cancer survivorship and symptom management for persons living with genitourinary cancer.