DEAR DR. GOTT: I'm a 72-year-old male. I've been going to a urologist for almost six years to have my prostate checked. He's never found anything wrong. I had a biopsy two years ago that was negative. Now he wants to do another. Six months ago, my PSA was 6.3. A month later, for the first time, I gave a urine specimen. That PSA came back 153. Do I need a second opinion?

DEAR READER: Lab values vary from hospital to hospital. When it comes to a PSA blood test, the normal range is between 0 and 4 at my local facility. The normal level may rise as men age. You are slightly high at 6.3; however, the PSA serum level has a number of drawbacks. Elevations can occur in some men because of benign conditions. Perhaps that was the case two years ago.

A urine biomarker test appears more accurate for early detection of prostate cancer and may reduce the number of biopsies currently being performed. At this stage, it appears a urine biomarker combination may be used to supplement the PSA. It is anticipated this test or one similar will replace the PSA completely in the near future, but more research is needed first. In fact, the February 1, 2008 issue of Cancer Research indicated the urine test has out-performed the PSA and prostate cancer antigen 3 (PCA3), a marker for early prostate-cancer diagnosis.

Studies are ongoing, and the research results appear promising. Early detection of any disease — especially cancer — allows for faster treatment and possible eradication. I'll keep readers posted on developments.

DEAR DR. GOTT: I have problems with mild dizzy spells that make me rather unsteady at times. I thought I would consult you for a possible solution. I have great respect for your answers and will look forward to a response.

DEAR READER: Thank you for the compliment. I wish your letter were slightly longer and included such things as your age, medical conditions and what medications you are taking. Without such knowledge, I am shooting in the dark.

I will provide a general answer, but am going on a hunch you are a senior citizen.

Knowing whether you are describing lightheadedness or vertigo will help answer a number of questions. Lightheadedness can best be described as the feeling that you are about to faint. You might feel nauseated and vomit during an episode.

Lightheadedness often disappears or improves when a person lies down. This may be caused by a harmless drop in blood pressure that often occurs when a person stands up from a sitting or lying position too quickly. It can also be brought on by stress, anxiety, heart arrhythmias, allergies, and more.

Vertigo feels as if you and your surroundings are moving when they aren't. This can be accompanied by a loss of balance and difficulty standing or walking. It can be brought on by such things as an inner-ear disorder, insufficient blood flow to the base of the brain and migraine headaches.

Changes in medication, drug excesses or interactions and alcohol are common causes of both conditions. Bring your concerns to the attention of your primary care physician.