Hi doctor,My query is related to PSA values. Please look into the attachment. The person is currently suffering from a thrombosed hemorrhoid vein. The treatment which the doctor has proposed is Movicol a stool softener 1-0-0, Daflon 2-2-2-0 for the first four days and afterwards for three more days 2-0-2-0, and Anusol a local cream to apply to the outside of the anus. My question is could the PSA values be related to the thrombosis syndrome? Or is there a reason to check the prostate gland independent of the lower intestine syndrome? What should be done in terms of the follow up of the prostate gland monitoring, tests, frequency, treatment and follow-up over time? Many thanks for your help and support.
Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. I will try to remain as simple as possible in my conversation so that everything is pretty much clear and easy understandable to you.  I have seen the prostate-specific antigen (PSA) values in your attached laboratory reports (attachment removed to protect patient identity). I appreciate the efforts you put in to upload the reports. I want to add that on looking only the PSA values in this range concludes nothing. We usually take this first reading as a baseline result and compare future results with this PSA level to see if the values are going up or down. The future values when compared to this reference baseline value, give us a clue if there is any disease and its progression or regression. Only the PSA levels especially the ones you presented in attachments never concludes that it is a prostate cancer.  Urologist has to take complete history to see if there is some blockage to urine flow due to enlargement of prostate. Actually prostate gland has a tough and non-expandable covering capsule around it. If there is any growth as a tumor inside this gland, it causes a pressure on the urethra. The urethra (urine pipe) is passing through this prostate gland en route to penis opening. Any local lesion causes the urethra to get obstructed causing issues with flow of urine (urinary symptoms).  Urologists may also go for serial diagnostic tests and radiological imaging studies to see if there is an abnormal growth inside. So an in-person evaluation from an urologist is necessary and to keep a follow up is the best strategy as I think he will go for look and see policy. He will go for a conservative approach or as appropriate.  Follow up may be done after 6-8 weeks for redoing the laboratory investigations and all that.  Regarding thrombosed hemorrhoids, I want to explain that it is a different disease and has little to absolutely no relation with the prostate as is in this patient.  Treatment given by the physician for hemorrhoids is all good to go without any change. Sometimes we have to send the patient for surgical resection of the thrombosed vein area. You have not uploaded pictures of the anus. Otherwise, I may have been in a better position to assist you in its management options that best suits in this specific patient. I also want to see and know the color of the anal lesion. Picture will also help to decide whether it is a healing or a non-healing hemorrhoid. Also please add, how long has he been having hemorrhoids? And since when these thrombosed veins are there? If there is still burning or any kind of discomfort in anal area, I suggest you to apply ProCort rectal ointment outside and inside using a special applicator that comes with the ointment. 1. Avoid constipation. Keep a judicious supply of fluids. 2. Bland diet is best for him. 3. Physical activity is necessary as much as possible easily. Revert back with the answers for the above questions to an internal medicine physician online.--->