Patient management tactics with primary detected prostate-specific antigen increase

The main screening test for prostate cancer is the determination of prostate-specific antigen (PSA) in the blood. Increasing of the PSA level above 4 ng/ml is an indication for a detailed clinical examination of the patient. At the same time only in a quarter of cases with a PSA level of 4 to 10 ng/ml prostate cancer is diagnosed, and in 7080% of cases prostatic hyperplasia and prostatitis are diagnosed. Objective: to determine the need for anti-inflammatory treatment in the initial detection of elevated PSA blood levels within the gray area in men over 50 years of age to minimize the number of puncture biopsies of the prostate. Materials and methods. The study was divided into 2 parts. Part 1 a retrospective study, in which results of the histological examinations of the prostate gland of 297 men after a puncture biopsy about an increase in the PSA level of more than 4 ng/ml were analyzed. Part 2 a prospective study in which 118 men over 50 years of age with a primary increase in the PSA level from 4 to 9 ng/ml received anti-inflammatory treatment to monitor the dynamics of the PSA level. Results: the appointment of anti-inflammatory treatment allows in 69% cases to avoid puncture biopsy of the prostate, increase the predictive value of PSA, reduce the frequency of post-puncture complications of inflammatory genesis. Conclusion: the appointment of anti-inflammatory treatment is advisable when the primary increase in blood PSA levels to 9 ng/ml.