DEAR DR. ROACH: I’m writing to you about an elderly patient who is currently 96 years old. For the last three years, his PSA score for his prostate has hovered around 30 ng/ml. He initially received an ultrasound and was determined that the prostate looked normal, despite the high PSA score. The general physician, under the following circumstance, referred the patient to a urologist. Subsequently, the urologist wrote back saying he would not be taking the patient due to age and that he would not be accepting any future requests.

More recently, due to a routine physical checkup, the PSA score is now at 105. The physician, thinking it might be a case of inflammation of the prostate, prescribed one month of antibiotics. It didn’t seem to assist the issue, and now the most recent PSA score is 207. The patient was told, due to the previous response from the urologist two years ago, that no further action should be taken, although it is now suspected that the patient has prostate cancer.