Persistent symptoms and the presence of the said organism suggest an ongoing infection despite previous treatment. She is strongly advised to seek the advice of the relevant specialist.
PSA of 19ng/ml may or may not be due to cancer of prostate. Ancillary imaging like plain MRI may provide more information if biopsy is declined. Staging should follow after confirmation of prostate cancer. Either radical surgery or radical radiotherapy will do for localised cancer. While radical surgery is good for the physically fit, radical radiotherapy is the alternative for those who refuse or are unfit for surgery. Tumour aggressiveness, patient profile and preference, treatment morbidity will shape the ultimate management plan. If the cancer has spread to other parts of the body, hormonal therapy and other palliative measures become the main stay of treatment.
Progressive rise of PSA beyond the normal range is suspucious of prostate cancer unless proven otherwise. Early diagnosis and treatment will certainly be conducive to better outcome. It worths seeking the advice of a private urologist asap or else there is no choice but wait in the public sector.
范健醫生(男)