Prostate and heart medication

[Graham1956]

Hi, I recently had a psa blood test which came back a little on the high side (4.5) so my gp has referred me to urology department at my local hospital. I just wondered if anyone else on this forum has had any issues with prostate? Could my problems be down to my heart medication? I no longer take water tablets as I’m now on new drug entresto heart team said I could stop diuretic’s. But still seem to need to urinate often, it’s a bummer. I really am praying that it’s not prostate cancer, feel I have enough to deal with due to heart failure. Look forward to any reply’s.

[Lezzers]

My husband has heart failure & he also has a prostrate problem. I get the fear bout cancer we too were worried but it's just slightly enlarged & he's on medication to stop him having to get up so frequently in the night. He's also on furosmide which is a diuretic, which we thought a bit odd as you would think one counteracts the other but apparently not. Cardiologist wants to get him on Entresto but his blood pressure is too low at the moment.

[Graham1956 in reply to Lezzers]

Thanks for reply Lezzers. My prostate is or was when checked 2yrs ago moderately enlarged with psa 3.6 now up to 4.5. The urologist at the time assured me there was no signs of cancer so hopefully that’s still the case. Apparently I’ll be seen due to gp referral within 2 wks. So See what tests I must go through then. I was told by gp not to worry it’s most likely not cancer but how do you not worry? Hope your husband can get onto Entresto soon, I’ve been led to believe it’s the latest wonder drug. Regards Graham.

[Lezzers in reply to Graham1956]

We're desperate for him to get on the Entresto they've been dangling it in front of him for bout 2 years now!! They're now reducing & possibly stopping his angina tablet to get his BP up so it's a slightly worrying time at the moment. But you have reminded me that kevins enlarged prostrate was diagnosed at least 2 years ago & he's not been followed up since, must get on to it. If it helps to know, Kevin's brother has had most of his prostrate taken away (not cancer related) and he had to re-train his bladder but has had no further problems with it at all & that was certainly over 5 years ago. Yes, easy to say don't worry but the GP hasnt got the problem!! However, do bear in mind (in the unlikely event) prostrate cancer is one of the most treatable & survival rates are very high.

[Graham1956 in reply to Lezzers]

Thanks for your positivity it helps. Best wishes to you and husband.

[Lezzers in reply to Graham1956]

Thank you and good luck with your tests

[Prada47 in reply to Lezzers]

Hello

Last visit to Cardiologist he stopped Furosemide 40mg and Isosorbide 25 mg trying to bring BP up so I can move to max dose of Entresto. I see Heart Nurse on the 12th when decision taken on when to increase. I must admit I haven't noticed much change since stopping Furosemide !!! BP has come up slightly 110/65 so just waiting to see. Cardiologist, he told me to record BP twice a day to see result of change !!! I take 7.5mg Bisoprolol and no change to pulse around 50 bpm. I do get up normally once in the night between 0245 and 0300 like clockwork lol. If I have noticed a change it is that passing pee has got slower !! hope that helps a little.

p.s. I do take Eplerenone which I believe is a diuretic as well as a BP medication.

regards

[Lezzers in reply to Prada47]

Thank you, Kevin is only on a low dose of candesartan & bisoprolol & is unable to take spironolactone due to potassium issues. His BP readings are similar yours but they want to try & up the candesartan & bisoprolol & see how he tolerates them before they can think bout Entresto. The trouble is that upping the meds will reduce his BP so a vicious circle really. GP now wants him to monitor BP for a week to see if the reduced isobard monitrate has increased it but it doesn't seem to have made any difference so far!! We're getting so desperate I may have to feed him salt!! (just kidding bout the salt) Kevin would certainly agree bout the slow pee, blooming nuisance when you're running late anyway!! Do you think 0245 to 0300 could be a routine you've gotten into and your body has trained itself to automatically wake up at that time?

[Bagrat]

Always good to have things checked out. The PSA does have for brevity " false positives" and this is one reason that until a more specific test for prostate cancer is available, any sort of mass screening would result in a lot of "worried well". In addition many men with prostate cancer may only need regular checks for many years ( known as watchful waiting) which can also cause stress as treatment may not be advantageous at that stage.

.

[Sim22]

Dear Graham

Firstly the PSA is not very specific , the results can vary so for example infection, sex, exercise, drug interactions can all increase the levels of PSA.

The most common cause for the increased level is Benign prostatic hyperplasia: A common, noncancerous enlargement of the prostate gland. The enlarged prostate may compress the urinary tube (urethra), which courses through the center of the prostate, impeding the flow of urine from the bladder through the urethra to the outside.

Taking medication to reduce the size of the prostate can reduce your BP .

If there is no history of prostate or breast cancer in your family history then the risk of cancer decreases.

Your urologist may repeat the PSA, examine the prostate DRE, and an ultra sound

Happy to char

Simon

[Graham1956 in reply to Sim22]

Thanks for taking time to answer my post Simon. God bless you.

[Leythersrus1]

Hi Graham

I had slightly raised PSA but after all tests ended up having TURP after being on medication to help with getting up in the night. Also was using catheters.

Been fine since. My brother did have prostrate cancer aged 44 but had all clear now he's 55.

Good luck.

[Graham1956]

Thanks for reply it helps hearing other people’s comments.

[Hidden]

Graham, I was diagnosed with prostate cancer last October after years of having to get up at night two or three times. My PSA never exceeded 4.5 and having had 3 DRE's by different GP's was diagnosed with BPH (enlarged prostate not due to cancer). I decided to try for a new treatment known as artery embolisation which blocks blood supply to the prostate causing it to shrivel up. This obviously had other side effects but I decided I would put up with those in return for removing the risk of cancer and getting a good night's sleep. I was therefore referred to an urologist who promptly gave me another DRE and immediately said "you do NOT have an enlarged prostate" and requested an MRI scan which showed a tumour subsequently diagnosed as malignant after a biopsy. I had surgery over Christmas to remove my prostate.

Five weeks ago I had my aortic valve replaced (open heart AVR) and was put on a powerful drug (Amiodarone) due to severe atrial fibrillation two days after the op. Oddly, the method used by urologists to monitor the possible spread of cancer after a prostatectomy is a PSA test every three months. My first two tests have proved negative (zero), so obviously these were not affected by the drug for AF (I had also been on statins Atorvastatin) since March to lower my cholesterol level).

I guess my message here is never to rely on GP's using DRE examinations (palpitating the prostate using a finger inserted in the rectum). If you have experienced the need to urinate frequently over a period exceeding a year, request a referral to an urologist as they will have the experience to make a genuine diagnosis. Your own GP has done exactly the right thing -just make sure you do not have to wait 4 months to see an urologist (which happened to me).

Mike

[Graham1956 in reply to Hidden]

Hi Mike really good to read your reply. I’ve got a urology appointment set for next Monday so pretty quick. Guess they’ll give me a full examination starting with DRE, MRI etc. I’m pretty sure prostate is enlarged for some reason just need to get to bottom of it. I already have HF with pretty poor blood pressure so think meds to shrink prostate may be limited for me. (I’m already taking usual cocktail of heart meds) just have to wait and see what happens. All the best Graham

[seasider18]

My PSA went up to 9.8 and I had two negative biopsies during that time. The high PSA was caused by my enlarged 75 grm prostate. Large prostate = high psa. Now after laser surgery on my prostate it is 0.70.

[Hidden in reply to seasider18]

PSA is an interesting measurement. My twin brother had a PSA of 19.5 and a biopsy indicated advanced cancer resulting in a prostatectomy. Ten years later by PSA had never exceeded 4.5 and I was also diagnosed with cancer. As you point out the converse can be true but you were given good advice as the only real test is a biopsy. It is rather unfortunate that this test is invasive (every time they take a tissue sample which has to be sampled from all parts of the prostate, the wall of the bowel is punctured by the biopsy needle). I had fifteen samples taken which apparently is average and I was glad I had a course of a powerful antibiotic beforehand. Glad to hear your laser surgery worked.

Mike

[seasider18 in reply to Hidden]

Last time in 1996 I had sixteen samples taken by a female Aussie urologist in Scotland. I said antibiotic she said I don't do antibiotics. I said local Anaesthetic. She said I don't do that either... write to the health minister about it. The penny dropped I had spoken to the recently retired head of urology about the Free PSA test that they had previously had funding for but the accountants had stopped. I asked him if it would help if I wrote to the minister who was my MSP about it and he had agreed.

The 16 needles went it and I swore each time. She came to see me in recovery and said that she was my urologist now as she had just been appointed head of urology. Later as I was about to go I started to Haemorrhage and had to stay overnight and later got an infection.

During the night a doctor on rounds asked why I was there. When I told him he said in Norway they call prostate biopsies PSA terrorism.

Less need for biopsies now with more sophisticated testing available. The Aussie she did not last six months.

[seasider18 in reply to Hidden]

According to the University of Pittsburgh Cancer Institute, a normal PSA reading ranges from 0 to 4 ng/ml. A reading over 4 ng/ml may give cause for concern, although many older men have high levels of PSA but no other health consequences