I am Dr. Saurabh Mishra, Urologist. Today I will discuss prostate cancer from the general public point of view. This is common cancer a male can have a lifetime. Although the possibility of prostate cancer in our country is lesser than the western countries, still it is a significant one. I have come across with so many patients coming to my OPD with high PSA level and assuring themselves that they have prostate cancer and come to my OPD for the treatment of prostate cancer. But let me tell you the majority of these patients, they do not turn to have prostate cancer because of lack of awareness in the general public.
Any high PSA level is considered as prostate cancer. But that is not the truth. PSA is a tissue-specific marker, not a disease-specific marker. That means patients who have higher PSA, just show that there is a high tissue level whether it is malignant level or benign one is totally depends upon the relative value. If PSA is less than 4 nanogram per ml so there is no prostate cancer, which is absolutely incorrect. If a patient has less than 1 nanogram, there is a possibility of having prostate cancer. In case, a patient is having PSA more than 4 nanograms, doesn't mean he has prostate cancer. It is all relative. If a patient has 10 nanograms of prostate cancer, the possibility may be 20.
That means still 80% of the patients may have non-cancerous high PSA. It is our responsibility as a Dr to explain and reassure these patients about the fact and truth. With higher PSA also, there is a possibility of low prostate cancer. I am not talking about those patients who have a very high PSA and more than 100-200. If it is a very high PSA, then it is sure shot cancer. This discussion is basically for those patients to align between 4 nanograms per ml to say 30 nanograms or 35 nanograms. So, with higher PSA, do not make any conclusion. Rush to the urologist and discuss the things that how it has to go with high PSA. You urologist can advise for prostate biopsy also but do not assume by your own. Leave it on your urologist as he is going to treat you properly. Do not assume anything.