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It is best to get an opinion from a urologist on these options.moonie: Are fluctuations in regular (every six months) PSA levels normal?Mine have ranged from 2.5 to 4.5 within a two-year window.Gro Ken Ha MMer: Eric_Klein,_MD: PSA is the best way to determine cancer risk, along with digital rectal examination (DRE), family history and a few other factors.

This would happen of course before the PSA reaches four.

This is why the values are different for monitoring rather than for screening.

Prostate cancer is a serious disease that should be diagnosed and treated early to provide the best possible outcome for healthy lives in men. Klein, MD, is Chairman of the Glickman Urological & Kidney Institute and staff physician in the Taussig Cancer Institute at Cleveland Clinic. He received his medical degree from University of Pittsburgh School of Medicine. Klein’s clinical interests are all aspects of urologic oncology, including cancers of the prostate, bladder, testis and kidney, and including all major reconstructive procedures such as continent urinary diversion.

Nicolas Muruve, MD, associate staff physician in Cleveland Clinic-Florida’s Department of Urology, in Weston, Fla, is a board-certified urologist. Muruve completed a research fellowship and a renal transplant/renal vascular fellowship at Cleveland Clinic following his residency in urology at the University of Manitoba Health Sciences Centre, in Winnipeg, Manitoba, Canada.

He completed his internship at Mount Sinai Hospital in Toronto, after graduating from medical school at the University of Manitoba, in Winnipeg. Muruve’s special interests are genitourinary oncology and renal transplantation. We are very excited to have both available to chat today!

Moderator: Welcome to our "Prostate Cancer: Diagnosis and Treatment " web chat with Cleveland Clinic Glickman Urological and Kidney Institute Chairman Dr. Eric_Klein,_MD: That is a typical symptom of prostate enlargement that can easily be treated with medication to relieve your symptoms.

As far as PSA change, this can be difficult to assess on single values, and should be done over multiple values to see the trend.

In general, the PSA velocity of 0.7 per year is considered acceptable.

In the great majority of cases, ED is a symptom of an underlying problem. Eric_Klein,_MD: I don't know of any direct evidence for this, although insulin is like a growth factor.

Its receptor has been implicated in prostate cancer progression.

I have recently had a 12-punch biopsy that was clear.

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