Prostate cancer care in Snellville, from an elevated PSA to a plan you understand

An elevated PSA: what it can and can’t tell us

PSA, short for prostate-specific antigen, is a protein the prostate releases into the blood, and a quick blood draw measures it. A higher number is a reason to look more closely, not a diagnosis. An enlarged prostate, an infection, inflammation, and even a recent cold or stomach bug can raise it for a while, and prostate cancer can raise it too. Often the first step is a repeat test once any illness has cleared.

We also weigh your age, family history and a digital rectal exam, a quick check of the prostate that can pick up changes a blood test misses. Your risk is higher if a father, brother or son has had prostate cancer, if you carry inherited gene changes such as BRCA1 or BRCA2, or if you are African American.

Prostate biopsy, when it’s needed

If the picture still points toward the prostate, our urologists may suggest imaging such as an MRI and a prostate biopsy, which takes small tissue samples for a pathologist to examine. Advanced Urology offers MRI-guided and micro-ultrasound biopsies, and many are taken through the perineum, the patch of skin behind the scrotum (a transperineal biopsy). We walk you through the preparation, what you’ll feel, and how long results take before anything is scheduled.

When cancer is found or suspected to have spread, imaging such as a PSMA PET/CT scan can help with staging. Dr. Dev Mally explains what to expect from a PSMA PET/CT.

Symptoms worth mentioning

Early prostate cancer often causes no symptoms at all, which is why a PSA result is how many men first come to us. When symptoms appear they can include trouble urinating, a weaker stream, needing to go often (especially at night), blood in the urine or semen, pelvic discomfort, bone pain, swelling in the legs or feet, weight loss you didn’t intend, or erection changes. Most of these have other, more common causes, and each one deserves a conversation.

Prostate cancer treatment options

The right path depends on the cancer’s grade and stage, your health and what matters most to you. Options offered at Advanced Urology include:

• Active surveillance for slow-growing cancer: regular PSA tests, exams and occasional biopsies, so treatment and its side effects can wait unless they’re needed
• Surgery, including robotic radical prostatectomy to remove the prostate when the cancer is confined to it
• Radiation therapy, given from outside the body or from radioactive seeds placed in the prostate (brachytherapy)
• HIFU, focused ultrasound for selected localized cancers; read what HIFU is
• Hormone therapy (ADT), which lowers or blocks testosterone, often with radiation or for advanced cancer; see our article on leuprolide (Lupron, Eligard)
• Chemotherapy, immunotherapy and targeted therapy for advanced cancer, and palliative care to ease symptoms at any stage

Every option carries its own trade-offs, including possible effects on urinary control and erections. Our urologists talk through each one honestly, and you’re welcome to bring someone with you. If radiation is part of the plan, ask about Barrigel and fiducial markers.

Where your care happens

Visits, PSA checks and follow-up can happen at our Snellville or Conyers office. Biopsies and many procedures take place at our Snellville Clinic & Surgery Center, 1557 Janmar Rd, with the same team you already know.