I am 68 and i know my prostate is big. I can't take medecines to reduce its size as i have had a heart attack and i feel these make me feel unconfortable possibly because they do not go well with my heart treatment.
As per when PSA levels show a potential cancer?
Hi Ed A large prostate usually will cause PSA levels that mimic the typical levels that call for prostate cancer biopsy. There are other factors and several new tests that may help you decide whether a biopsy is your next step...including an MRI. Best thing is to find a great urologist and have a good talk about the specifics of your health.
Thanks very much i have the same view that finding a great urologist is my priority. But that is not so easy.
Hi Ed,
To my knowledge, 5-alpha-reductase inhibitors (Proscar or Avodart) do not have contraindications for heart patients. They interfere with the conversion of testosterone into DHT and don't affect BP at all. DHT is responsible for much of the prostate enlargement. Alpha-blockers (like Flomax) reduce BP and improve urine flow, but do not actually shrink the prostate. You should talk to a cardiologist before taking those.
There are a number of things that can be done to decrease the size of your prostate, one being a TURP surgery. That's a trans uthural resection of the prostrate. I had it in 2011 and thats who they found my cancer. Had that taken care of at MD Anderson in Houston, Texas in 2011. Wish you the best.
Michigan Jim
Ed,
As you know, PSA is not a test specifically for cancer, and there is no cut-off that differentiates cancer from non-cancer. The latest NCCN guidelines suggest that if PSA is over 3, it should be repeated, along with a DRE, and the presence of benign disease should be investigated. A rule of thumb is that your PSA divided by the size of your prostate (called "PSA density") should not be much greater than .15.
If you should decide to take Proscar or Avodart, it actually makes PSA a much better indicator of prostate cancer because it reduces the PSA due to BPH, but not the PSA due to PC. If it then fails to go down, or if it goes down but then goes up, it's time for a biopsy. It also improves the ability of the biopsy to detect cancer.
There is an inexpensive and insurance-covered blood test that is somewhat more sensitive and specific than PSA (it includes PSA and a couple of other things). It's called the Prostate Health Index (or PHI). You have to go to a local urologist who offers it, and you can get a list of local urologists by calling the number at the following link: myinnovativelab.com/prostat...
There are other expensive tests, but they and advanced imaging, like MRIs, aren't usually covered before a first biopsy, unless there is justification and usually not even then.
Thank so much for your enlightments. Being not english speaking by nature i need to look at some of your explanations and abreviations to make sure i understand correctly. Sorry to look stupid but the subject is of interest to me and you seem to be willing helpful to each other.
Excusez-moi, Ed. Je vais traduire les abréviations:
DHT= dihydrotestosterone:a powerful androgenic steroid
BP=blood pressure
NCCN= National Comprehensive Cancer Network: many of the best cancer hospitals in the US
DRE=Digital Rectal Exam: un doigt au cul
BPH=Benign Prostatic Hyperplasia: enlarged prostate
PC=prostate cancer
The PHI test is available in Paris. Ask your urologist.
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