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Question on best med to shrink prostate

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Posted 1/11/2019 5:49 PM (GMT 0)
Ok I don't have PC,,,that I know of...59 yrs old, psa is 1.64....enlarged prostate for the last 10 yrs...Uro did the digital yesterday...said " yup it feels boring, enlarged, 55grams,boggy"...
I do have a weak stream...he said " we could try I think he said Finistride....he said it would shrink the gland ...
I was reading the side effects....is there a better on or what experience has anyone you guys know that have taken it had ?
Thx
Posted 1/11/2019 6:28 PM (GMT 0)
It's a good drug. Flowmax is another one. There are a lot of drugs on the market, but they come down to a couple of groups: 5-alpha reductase inhibitors and alpha blockers.

Each person is different and responds differently to each med. Uros often just start with one and see what happens. If it's not working or the SEs are bad, they are others you doc can switch you too.

Andrew
Posted 1/11/2019 11:59 PM (GMT 0)
Pygeum is a natural substance that is the base of almost all of the "prostate Health" formulas. Buy it from amazon and get just the pure Pygeum bark ( it comes from a pine tree from Africa.

It works well. No side effects

Roger
Posted 1/12/2019 12:44 AM (GMT 0)
I was on Finasteride for six months prior to PCa diagnosis. I don’t recall that it improved my flow for the relatively short time I was on it. I recall the PCP saying it would take over six months to start noticing improvement.

There is a lower dose version called Propecia for baldness. Apparently our President uses this drug.

I researched the side effects of these drugs and discovered there is a community of people claiming terrible permanent side effects.

I’m unaware of alternative medications.
Posted 1/12/2019 1:47 AM (GMT 0)
Another alternative that sometimes works is saw palmetto (also frequently in prostate supplements). Note that all of these drugs will lower PSA, which can mask cancer detection.
Posted 1/12/2019 2:19 PM (GMT 0)
Actually it doesn't mask cancer detection. What they do is reduce the "healthy" PSA as a result of a smaller (less prostate cells producing) prostate. So if you have PCa the PSA produced by the unhealthy cells are more evident.

What is needed is a baseline with the PSA lowering supplements/drugs when it is known there is no cancer OR be much more sensitive to an upward trend in the PSA.

Again, as in all things "Prostate" it is most important to be informed and thoughtful.

May all beings be well.

Roger
Posted 1/12/2019 5:57 PM (GMT 0)
As I learned the hard way, it may be wise to demand a 4K score, and a Prostate Health Index (phi) blood test, at a minimum. If your doc doesn't have hands on experience with them, or soft sells them...change urologists to one who keeps current. You need to make certain cancer isn't percolating in your prostate.

Good luck!
Posted 1/13/2019 3:05 AM (GMT 0)
By the term "mask", the rule of thumb that I was exposed to was that if you're on flomax or any of the other BPH drugs or supplements, your PSA will be approximately 50% of what it would be without it. So, if you're on one of these meds, if your PSA comes back at 4, double it.

This is the point where the single, most important PSA comment comes into play: PSA is NOT A CANCER TEST! PSA is an indicator of prostate activity or irritation. High PSA needs to be checked out, and it's good to keep an eye on it--but there are a lot of things that can cause PSA to go up, and cancer is only one of them.
Posted 1/13/2019 1:54 PM (GMT 0)
What Halbert said about several things that can cause PSA to rise.
So: if we are dealing with a healthy but large prostate which is producing let's say a PSA of 6.0 and one begins taking any one or combo of these drugs/herbs that lower PSA one could expect to see a PSA of 3.0 once the drug/herb is fully functional. The reason for this seems to be that it has reduced the size of the prostate so there are fewer healthy cells producing PSA. Stopping the drug/herb will then allow the prostate to begin growing again and the PSA will increase.

Now let's take a prostate that has healthy cells and cancerous cells. Let's say, for the sake of discussion, that the PSA is 6.0 of which half comes from unhealthy cells and half from healthy cells. It is my understanding that these drugs/herbs do not reduce PSA production by the unhealthy or cancerous cells so one would expect to see the PSA drop by 25% or down to 4.5

The questions are of course:
1. Do these drugs/herb truly cut PSA by half?
2. Do these drugs/herbs only affect healthy prostate tissue?

If only we could get definitive answers about many things prostate we would be so much better off but as we can't all we can do is be well informed and then make personal decisions that we are comfortable with. These decisions will differ from person to person because there is seldom ANY solid definitive answers when it comes to PCa.
Posted 1/13/2019 5:47 PM (GMT 0)

halbert said...
By the term "mask", the rule of thumb that I was exposed to was that if you're on flomax or any of the other BPH drugs or supplements, your PSA will be approximately 50% of what it would be without it. So, if you're on one of these meds, if your PSA comes back at 4, double it.


I've heard/read of that using PSA doubling 'rule of thumb' if you're on finasteride or avodart but not for flomax/tamsulosin and the other alpha blocker drugs, which leads me to question my post treatment PSA results because I'm still taking tamsulosin daily.
Posted 1/13/2019 10:33 PM (GMT 0)
Kent, I don't know if the same rule applies post radiation/Lupron--the treatment changes pretty much everything. That is a good question for your RO.
Posted 1/14/2019 2:05 AM (GMT 0)
I have been on and off "Flowmax" 3 or 4 times since SBRT a year ago. Sorry to say I did NOT track the dates when I was using it as compared to the dates of my quarterly PSA tests. All I can say is my PSA has continued on a downward trend.

I will state again: PCa is a strange beast in that there are no set rules to go by. One must do his due diligence of research and then make the decision he is most comfortable with.

May all beings be well and free from animosity.

Roger
Posted 1/14/2019 2:51 AM (GMT 0)
5-alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth. These medications — which include finasteride (Proscar) and dutasteride (Avodart) — might take up to six months to be effective. Side effects include retrograde ejaculation.

I've been on Finasteride 5+years now. I tolerate it well. As for the retro grade ejaculation SE, well my radiation treatment took care of that, meaning I don't have any to retro

All meds have side effects. If you read all the possible side effects with any drug, you may never take anything out of fear.

I had a weak stream from an enlarged prostate, but I also had a growth partially blocking the urethra, needed a green light {a little off the top} procedure, even after prostate was shrunken.

On it now for maintenance, my RO thinks I need to continue 5mg daily for life, as I'm just one of those guys who likes to grow prostate tissue.
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