To many years I have had an enlarged prostate, and my PSA blood tests are extremely high. 

But a biopsy and two MRI scans show I don’t have cancer. Another MRI is recommended. 

I really don’t want to as it makes me claustrophobic. 

It’s a good idea to have one just in case.

An invasive blood test known as a PSA Test checks for any signs or symptoms of prostate cancer.

PSA is an acronym for protein specific antigen. It’s a protein found in blood. Although high levels can be a sign of cancer, they may also indicate other health conditions.

Prostatitis is a condition that causes inflammation and swelling of the prostate.

A reader who is scared of confined spaces today asks DR ELLIE CANNON whether he should have an MRI scan to check on the health of his prostate gland

A reader is afraid of confined spaces and asks DR ELLIE CANNON if he should get an MRI to assess the health of his prostate gland. 

PSA testing is useful for screening and diagnosing prostate cancer, however they cannot be relied upon 100%.

We know that false positives can result from certain tests.

MRI scans of the prostate are helpful to avoid unnecessary biopsies – when doctors take a sample of tissue to check for cancer – which are invasive and painful. MRI scans of the prostate can confirm that there is no cancer and should be done before a biopsy.

A patient and urologist can agree to not investigate further if the PSA level is high despite having two MRI scans done and a normal biopsy.

The time between the last MRI and now, as well as other risk factors will affect this. Black men are more likely to develop prostate cancer than men older than 70.

Because it’s non-invasive and painless, MRI scanning is low risk. However, some patients find them extremely uncomfortable. Some clinics have both upright MRI scanners and wide-open ones to help make it easier.

To see if levels rise, it might help to have several PSA tests performed by the doctor over a period of time. This may allow doctors to make an informed decision about whether or not it’s time for further investigations.

My hair is falling out. 

My doctor has confirmed that I am fit, have enough iron, and adequate thyroid hormone levels. 

This is the problem that causes me extreme distress. Are there any solutions?

It may sound trivial, but hair loss can have a devastating effect on both men and woman.

Losing hair can have many possible medical causes.

   

For Sunday’s Mail, Dr Ellie Cannon will continue to provide more information…

The first is an under-active thyroid – the butterfly-shaped gland in the neck responsible for metabolism. It is essential to have blood tests done in order to determine the health of this gland.

Iron levels might be a factor in hair loss. In blood tests, doctors look for something called ferritin, which indicates the body’s long-term iron stores, rather than the iron circulating in the blood. For hair growth to occur, ferritin must be within the normal range.

The menopause can also cause hair loss, which is due to a drop in oestrogen. A higher level of testosterone may cause hair loss, a receding hairline, and finer hairs. Many women report that hormone replacement therapy improves hair growth and thickness. Minoxidil can be used to stimulate hair growth.

Additional reasons that can cause excessive hair loss and thinning are stress, crash diets, side effects of medication, trauma, and excess anxiety.

You can identify the root cause of the hair loss by looking at the patterns.

Are there any bald patches or is the hair thinning everywhere? Alopecia areata is an autoimmune condition that causes sudden balding.

This can be shocking to those with the condition, but hair will regrow.

How much water should I drink? 

I am a healthy 76-year old. I was a water-suffering person for most of my adult life, yet never felt dehydrated. 

Recenty, my daughter advised me to drink more water. Now, however, I need to urinate 10-12 times per hour. 

I am getting to an age where I can’t hold back as well as I used to. Does this sound normal?

This is a great example of the dangers associated with trusting folklore about health rather than science.

Diet gurus have long been obsessed with water-drinking – how much to drink and how often. The truth is, most people don’t need to carry around a water bottle.

The standard NHS advice is to have roughly two litres of water daily – about eight small glasses – but this isn’t a hard- and-fast rule.

Diet gurus have long been obsessed with water-drinking – how much to drink and how often. But the truth is that most people do not need to be walking around clutching a water bottle

Diet gurus have long been obsessed with water-drinking – how much to drink and how often. However, the reality is that many people don’t have to constantly be carrying water bottles around.

Also included in this amount is fluids from other beverages such as soup, tea and fruit, and drinks like tomato sauce, apple juice, and water.

Water needs vary depending on weather conditions, activity and individual health.

I argue against the standard two-litre guideline – it’s far more sensible to monitor your urine colour and feelings of thirst, and drink according to that.

You can also go as many times per day as you like. There’s no standard. It is possible to drink too much water if you have to be there frequently and find it hard.

Particularly for older persons, excessive water consumption can cause more harm than good.

For those who cannot get the booster, I am afraid

Like most of you, I expect, I keep hearing about snags and problems with the booster jab rollout. 

Do you have a question for Dr Ellie?

Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

Dr Ellie is unable to answer individual questions or provide personal responses. She can only respond in general terms. Always consult your GP if you are experiencing a medical condition.

The most recent report to reach me concerns the husband of a friend who’s currently in hospital, having cancer treatment. 

She wants him to have a booster, but the doctors and nurses on the ward say it’s not their job to give it to him.

My friend wanted to know if her husband could be pushed in a wheelchair down the road towards a hub. But she said no. ‘He’s too vulnerable,’ they told her.

People who are housebound can book to have a shot at home, but he’s likely to be in for a good few weeks, if not longer. 

So they’re stuck, boosterless. It’s causing them quite some worry, as the longer people are in hospital, the most likely they are to come into contact with the virus.

I was curious if anyone out there is in the exact same situation, being stranded at hospital with a booster shot so close and yet so far. 

Let me know if you have any questions.

People in hospital are finding it difficult to get booster jabs despite being at increased risk of coming in contact with Covid-19

Patients in hospitals are having difficulty getting booster jabs, despite the fact that they may be at greater risk for coming into contact with Covid-19. 

Lots of prescription fees

I am hearing more complaints from patients about sky-high prescription costs.

Although there’s a flat fee for one prescription, some patients – such as those with asthma – rely on several items at a time, which can set them back hundreds of pounds.

It’s a problem that I have always been deeply concerned about: specifically, the ridiculous rules governing charge exemptions.

Because I do not have any serious thyroid conditions, for example, I am exempted from paying charges. Patients with chronic severe asthma must pay.

I’m interested to know if you pay for your prescriptions, and whether you think it’s fair.