Raised PSA – what next?

taken from Small Gland, Big Problem 4th Edition
by Professor Roger Kirby, Health Press 2011

If your GP finds that you have a raised or rising PSA level (usually above 4 ng/mL, but in younger men above 2.5 ng/mL), or a reduced percentage of free PSA (less than 18%) you will probably be referred to a urologist – a specialist in disorders affecting the kidney, bladder and prostate in men (and the urinary tract in women). It is important that you feel comfortable with, and confident in, your urologist. You should understand his explanations of procedures and options, and he should be prepared to discuss fully anything that concerns you or your partner. In this day and age, do not simply accept that the ‘doctor knows best’ – it is your health and peace of mind at stake here, so make sure that you have had all your questions answered before you leave the consultation room. If you or your family are not happy with your urologist, go back to your GP and discuss the matter with him.

Alternatively, you may want to find your own specialist on a private basis. If this is the case, the first thing to do is to check your health insurance, if you have it. Some companies will not cover your expenses unless you have been referred by your GP. Also, you (or your insurers) may want to check the prices of treatment at an early stage. The clinic should provide a price list for you – if they do not, talk directly to the urologist. If you are not happy with your service, talk to the clinic manager or the urologist directly – you are a prospective customer and they will be unlikely to want to ‘lose’ you. If you are still not happy, go back to your GP and discuss the issue.

If you find it difficult to voice your concerns face-to-face or if you feel that you might forget some things, write a letter or list so that you can make sure that all your points are answered. It may also be useful to take your partner with you to the consultation, as two people will pick up more information than one. Taking a look at some of the websites listed from page 102 onwards may also be helpful, and these days you can find out about the doctor who is treating you, and the hospital or clinic in which he or she works, from the internet.