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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35034
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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In May/10, my PSA showed a reading of 1.5 following one 4-5

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In May/10, my PSA showed a reading of 1.5 following one 4-5 years earlier of 0.75 My PC doctor referred me to urologist for digital exam. An abnormality was found. Urologist commneted that 50% chance of prostate cancer. Plan was for Free PSA test 90 days following previous PSA result. Lab req filled out incorrectly and std PSA test run. Result was 1.0; urologist now recommending to not proceed with free PSA and monitor every 6 months std PSA. Would these reults indicate that I do not have prostate cancer? Seemed to have evolved from high concern regarding possible prostate cancer to now almost seemingly no worries from the urologist standpoint. Confusing and unsettling.
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 years ago.


Was a transrectal ultrasound done?

What was the abnormality found on digital rectal examination?

Dr. Arun

Customer: replied 6 years ago.
No ttransrectal ultrasound was done or recommended.
Customer: replied 6 years ago.
Believe it was described as a hard spot... beyond that, don't remember particulars
Expert:  Dr. Arun Phophalia replied 6 years ago.


Criteria to proceed for the prostate biopsy are;

1) High PSA; more than 4.

2) Ratio of free PSA and PSA

3) Digital rectal examination (DRE) findings

4) Trans rectal ultrasound (TRU) findings.

In your case, if there was any abnormal finding on DRE, a trans-rectal US should have been done to confirm the DRE finding. I feel that urologist was not much convinced about that abnormal finding himself, so advised for the free PSA and did no get the TRU.

With PSA decreasing, you may get the ultrasound and if it comes back to normal, you may not need biopsy.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Dr. Arun

Customer: replied 6 years ago.
Any comments regarding the probability of cancer presence... that is a compelling concern of mine. I was lead to believe that decline in baseline PSA was indicative of non-presence on cancer; but am not clear if that was the message. My PC doc is great; not so sure about urologist.
Expert:  Dr. Arun Phophalia replied 6 years ago.


A fall of PSA is a good evidence of absence of cancer. Even a 1.5 was never alarming (even if you compare it with the last PSA of 0.75 as minor fluctuation occurs and this rise can be just because of sex in last 2-3 days!).

So, again to re-emphasize, cancer is not probable. To confirm it, you may go ahead with the ultrasound.

It is privilege assisting you.

Dr. Arun

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