Move Slowly and Cautiously

My patient, let us call him Bill, narrowly avoided disaster. He came to me at his routine appointment and explained that his PSA was 12.4 and he was told he likely had Prostate Cancer and they wanted to do a biopsy immediately.

I said,

“Whoa, hold your horses, PSAs are notorious for False Positives, and you my friend are taking Testosterone, a known cause for elevated PSA. You do NOT need a prostate biopsy. You need time off Testosterone, and you need to calm down and wait. I can almost promise you, based upon the PubMed literature, that within months your PSA will come back down to normal.

I could see the fear in his eyes. The Urologist had scared the daylights out of Bill, and he was convinced he had cancer at the tender age of 53.