Dear Dr. Roach: I am 66 years old and in fair health, but lately I have been having more and more trouble coming up with simple everyday words. Are there any over-the-counter vitamin supplements worth using? I am currently taking some vitamins, as well as medication for neuropathy and blood pressure. –J.B.
Answer: There is still no convincing evidence that OTC supplements reduce dementia risk. A healthy diet high in fruits and vegetables, such as a Mediterranean-style diet, and regular exercise are much more likely to reduce your risk of dementia and also reduce your risk of heart disease. Controlling blood pressure is also important.
Dear Dr. Roach: I am a 74-year-old man in relatively good health. The only prescription drug I take is amlodipine 5 mg. My problem is the PSA score. In 2004 I had a urinary tract infection and my urologist told me I had an enlarged prostate. My score at the time was he was between 1.5-2 ng/mL. He then performed a laser procedure to open my urethra.
By February 2014, my score was 5.13 ng/mL and I had 12 prostate biopsies done by another urologist. The result was negative. In January 2019, my score was over 6ng/mL, and I underwent genetic testing and found that my chances of having cancer were low. By March 2021, my score was 8.18 ng/mL and I had a fusion biopsy. Suspicious spots were detected and targeted, and 13 samples were taken. The results were again negative.
In April 2023, my score was 10.29 ng/mL and I had another fusion biopsy. Again, suspicious spots were detected and targeted, and once again he had 13 samples taken. No one knows if the suspected area is the same, but the result was negative. My most recent PSA score was his 12.71 ng/mL in December 2023.
I have had lymphoma three times and had an autologous stem cell transplant in 2016. All doctors say this has nothing to do with my prostate problem. My brother had prostate cancer and was successfully treated.
My question is, is this something I should continue to do every 2 years for the rest of my life, or am I out in 3 strikes? Although I am still sexually active, this is not a very pleasant procedure as it takes over a month to recover. — Ku
Answer: Considering 3 sets of biopsies (2 of which were from MRI and ultrasound (“fusion biopsies”)) and genetic testing with no evidence of cancer, there are currently 13 positive results. , it is unlikely that another biopsy will be positive. A year ago, it was negative. My research confirms that stem cell transplants for lymphoma do not appear to increase the risk of prostate cancer.
But you have a family history, and when you plotted your PSA levels against time, your current PSA levels appeared to be increasing faster than they have in the past 10 years.
One option involves a biopsy only if a repeat PSA test confirms that the levels are increasing faster than before, or if there are suspicious areas that appear to be getting worse than before. Repeat MRI. I also read that finasteride reduces the risk of prostate cancer by shrinking normal prostate tissue, making it easier to diagnose cancer. It might be helpful.
Further advice
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