[Hyperplasia y prostad]High PSA = Prostate cancer? Doctors debunk the myth: or prostatic hyperplasia – Hong Kong Economic Times – TOPick – Health – Doctors’ consultation room

A male patient with a PSA index (prostate specific antigen level) above 4 on a blood test was referred to the urology department. “Is this cancer?” he asked nervously.

I explained to the patient, “The PSA number reflects the proteins secreted by the prostate. An index of 4 to 10 has a 1 in 5 chance of cancer; 10 to 20 is more likely to have cancer. Don’t worry too much, because of the number Elevated levels are not necessarily caused by cancer, but can be caused by inflammation of the prostate or benign prostatic hyperplasia.”

Prostate hyperplasia (hypertrophy) is mainly a natural aging phenomenon and is very common. The most basic tests are urine and blood tests. If there are bacteria in the urine, it means that the urinary system is inflamed and can be treated with antibiotics. In addition, a blood test can check for kidney problems that interfere with urination.

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Urination is also a basis for diagnosis. The normal size of the prostate gland is like a walnut. If it grows, it will compress the bladder and urethra, causing lower urinary tract symptoms. The patient said, “I have had difficulty urinating in recent years. I have to urinate all the time, I have a sudden urge, and sometimes urination is intermittent, dripping, and unclear…” However However, the position of urination is a subjective feeling, and doctors also have methods to oppose the data.

For example, the doctor instructs the patient to keep a “urine diary” to record the frequency of urination between meals, the state of nocturia, the amount of urine measured by the measuring cup, and whether there is any leakage of urine, etc. Generally, three days is enough. Medically, it is normal to urinate two liters and urinate 6 to 9 times a day. Some patients only “believe” that their toilet habits are normal after they have finished their diary, but it is just hypochondriasis. There are also patients who urinate dozens of times a day, hundreds of milliliters each time, which is abnormal and may be related to diabetes or hormone deficiency.

In addition, a urine velocity test can help diagnose symptoms. If the urine flow is too slow, it may be because an enlarged prostate is pressing on the urethra. During the examination, the patient can drain the urine into a device with a funnel device, and the flow and intensity of the patient’s urine can be measured. After the test, the doctor may use an ultrasound to check for any urine left in the bladder for further evaluation.

General benign prostatic hyperplasia can be treated with drugs, but if the drug does not work well and the patient has persistent urination problems, further examination is necessary. For example, a transrectal ultrasound is to insert the instrument probe from the anus to the rectum, and use ultrasound to measure the size of the prostate, whether there is a tumor, or to observe the residual urine volume in the bladder, whether there are stones , and so on. If the doctor suspects that the patient has bladder disease, it is necessary to carry out a cystoscopy (Cystoscopy), which is inserted through the urethra to examine the condition of the urethra and bladder. Finally, if prostate cancer is suspected, a biopsy of the prostate tissue is carried out to see if there are any cancer cells under a microscope.

After diagnosis, it turned out that the patient has hyperplasia of the prostate gland, since the medicine failed to cure the problem of urination, he underwent an “electrocution” operation to cure the hyperplasia of the prostate tissue. After the patient was diagnosed with prostate cancer, he was relieved, but he still asked nervously, “Can benign prostatic hyperplasia become cancer?” I replied, “Don’t worry! Prostatic hyperplasia is a benign tissue growth, while prostate cancer is abnormal cells. There is no absolute relationship between these two diseases, and most benign prostatic hyperplasias are harmless and do not cause cancer.”


Wang Mingxi, a specialist in urology.

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Written by: Specialist in Urology, Wang Minghao Hong Kong Medical Centre

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