His PSA Was 16. But That Wasn’t the Number That Worried Me

A man in his 60s feels healthy, but his PSA has climbed above 16 and his MRI shows a PI-RADS 5 lesion. With the focus firmly on prostate cancer, Dr. Stephen Petteruti asks a different question: what else was wrong?Dr. Petteruti follows his patient’s story and challenges the idea that PSA alone should determine whether a patient’s treatment is successful. He discusses his approach to biopsy, monitoring, repeat MRI and PRECISE scoring, and why he always considers disease stability, symptoms and quality of life alongside PSA trends.Then another test changes the picture. A coronary calcium scan reveals a score over 900, uncovering a significant cardiovascular risk that had received far less attention than the patient’s prostate cancer.Through the episode, Dr. Petteruti explores a larger question: when treating cancer, are we focusing so closely on the disease and its numbers that we risk overlooking the health of the person living with it?Timestamps: (00:29) How should we define successful prostate cancer treatment? (01:52) A patient with a PSA over 16 (02:30) What a PI-RADS 5 MRI means (03:08) Dr. Petteruti’s perspective on prostate biopsy (04:59) Stability versus curing prostate cancer (06:59) Using MRI and PRECISE scoring to monitor progression (08:10) Looking beyond prostate cancer to overall health (10:16) The heart scan that revealed a calcium score over 900 (11:31) Does lowering PSA always mean treatment is working? (12:08) When treatment becomes focused on the number instead of the patientEnjoy the podcast? Subscribe and leave a 5-star review on your favorite platforms.Dr. Stephen Petteruti is a board-certified physician specializing in longevity-focused, integrative medicine. He works with men navigating prostate cancer, testosterone, and hormone health, aging, and performance using proactive, evidence-informed strategies grounded in real clinical practice. His approach prioritizes preserving function, strength, and quality of life while helping patients make clear, informed decisions beyond reactive, fear-driven care.📚 ResourcesDr. Petteruti Men's Vitality Grouphttps://www.intellectualmedicine.com/membershipFight Cancer Like a Manhttps://www.amazon.com/Fight-Cancer-Like-Man-Breakthrough/dp/B0GP6JHQTQDr. Petteruti's Newsletterhttps://drstephenpetteruti.substack.com/subscribePodcast Show Noteshttps://www.intellectualmedicine.com/podcast-notes🌐 Learn MoreDr. Stephen Petterutihttps://www.drstephenpetteruti.com/Intellectual Medicinehttps://www.intellectualmedicine.com/📱 Connect with Dr. PetterutiInstagramhttps://www.instagram.com/dr.stephenpetteruti/Facebookhttps://www.facebook.com/dr.stephenpetteruti🎧 Listen to the PodcastApple Podcastshttps://podcasts.apple.com/us/podcast/intellectual-medicine/id1458649409Spotifyhttps://open.spotify.com/show/3om1BQGP8f0hODZ6neWCd1#Overdiagnosis #ProstateHealth #MensVitality #ActiveSurveillanceDisclaimer:The content presented in this video reflects the opinions and clinical experience of Dr. Stephen Petteruti and is intended for informational and educational purposes only. It is not medical advice and should not be used as a substitute for professional diagnosis, treatment, or guidance from your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your health regimen or treatment plan.