DEAR DR. DONOHUE: I am 64. I have been with my doctor for four years. This is the first timeI have had a blood test that shows I’m out of the range for PSA. I feel good 98 percent ofthe time. What do you make of this test? What are my choices? — M.T.
ANSWER: PSA — prostate specific antigen — is a blood test devised for the early detection ofprostate cancer. It’s not a foolproof test. Sometimes it’s high when there is no cancer, andsometimes it’s low when there is cancer. our laboratory puts its upper limit of normal for PSA at 4 ng/ml. Your value is slightly higher – 5.27. What’s the significance of that elevation? That’s a tough question. It could be only a gland that is larger than normal. A rise in PSA is also seen for 48 hours after anejaculation. Before any steps are taken, it would be wise to have the PSA repeated. etting the upper norm for PSA is fraught with difficulty. Other considerations have to bemade before a definite plan of action is taken. One is age. Another is family history(father, brother) of prostate cancer. And a third is size of the gland. f the second test is above normal, your doctor might suggest a prostate biopsy or thedoctor might decide that a period of watchful waiting would not put you in danger. Thedecision rests on these other factors I mentioned and on the amount of anxiety the testgives you.
At any rate, you need to have a frank discussion with your doctor not only about your PSA test but also about your blood sugar. You enclosed your test results, and yours is a valuethat strongly suggests diabetes. Make an appointment and kill two birds with one stone.
The booklet on prostate cancer and prostate enlargement presents the facts concerning these common male problems. Readers can obtain a copy by writing: Dr. Donohue – No. 1001, Box536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am a woman of 80 years. Early in 2007, I was wakened in the wee hours by a sweating attack like nothing I have ever heard of. I was saturated and was forced to get up and change my nightclothes. Since then I have suffered every night. I have been to my doctor, who tells me I have an illness, hyperhidrosis. He prescribed two medicines that made me feel worse than ever. Can you help? — A.F.
ANSWER: The first order of business is making sure you don’t have an illness causing these night sweats — cancers like lymphoma (lymph node cancer), infections such as TB, a drop in blood sugar, an overactive thyroid gland or diabetes. Night sweats are sometimes an exaggeration of a normal process that occurs during sleep. At night, body temperature drops.
To effect this temperature drop, the body sweats. Evaporation of sweat cools the body. What can you do to have your body produce a less florid temperature drop? Make sure your bedroom is cool and has a low humidity. You might need a fan blowing on you. Cover yourself only with a thin blanket. Don’t drink anything with alcohol in it in the evening, and don’t eat spicy foods at dinner. It’s best to fight night sweats without medicines.
DEAR DR. DONOHUE: My husband’s PSA level has risen, and the doctor says he want to conduct a biopsy. Exactly what does this entail, and what does it show? — R.M.
ANSWER: Biopsies are small pieces of tissue examined with a microscope to detect cell changes indicating cancer. They are the ultimate cancer tests. One way to obtain a prostate biopsy is by way of instruments inserted into the rectum. The rectum and prostate gland are next-door neighbors. Guided by ultrasound, the doctor can obtain specimens with a spring-loaded device that quickly directs a needle into the gland for samples. Many samples are taken. It’s an office procedure, usually.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletter.
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