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User

Posted 28 Apr 2023 at 12:22

I'm 69 years old. Currently living in Tokyo. Gradually over maybe the last 2 years my pee pressure became less and took more time and I started to pee more often, also during the night. I'm sure I have an enlarged prostate as this fits the symptoms as well as my age. 2 weeks ago, during night, I needed to pee but nothing came out, I went again and again, but nothing and it started to hurt. My daughter inlay booked a meeting with an urology clinic and we went the next day. My Japanese is not good enough to have more complicated conversations so she came with me. There they did blood and urin tests, and prescribed Tamsulosin and asked me to come back 2 weeks later for test results.

The 'not being able to pee' issue did not come back, everything is like it was before. I'll have to add that I usually don't take any medication and visit a doctor or hospital rarely if ever. I live a healthy and active life, no nicotine, very little alcohol. I did not take the prescribed Tamsulosin, what I read about it was not very encouraging.

2 weeks later, I returned today and my test result PSA number is 12. The doctor advised me to do an MRI and then go from there.

I'm on the fence if I should do the MRI fearing that this will be just the first of never-ending testing and who knows what other procedures. Besides the obvious abnormal PSA number I don't have any other issues.

Any suggestions from people with more experience than I appreciated.

User

Posted 28 Apr 2023 at 14:37

Hi Keenast,

I used Tamsulosin for many years to aid urinating without issue. In 2021 other symptoms resulted in the sequence of blood tests, MRI, biopsy, leading to surgery for stage 2 prostate cancer. Surgery 18 months ago has been successful and I am now in remission.

My view has always been to follow the science and medical tests as required to get a full and proper diagnosis and then treatment and I am very glad i did.

I have a relation in Australia who was diagnosed with stage 4 brain cancer and given just months to live, who then was put on a new treatment such that his cancer is now in remission too.

With all the current medical processes and advancements, life is too precious not to follow the science if required.

Edited by member 28 Apr 2023 at 15:55 | Reason: Typo

User

Posted 28 Apr 2023 at 15:39

I couldn't have put it better. Sixty nine is well below the average lifespan for a European (which I assume you are and Japan is well up there with technology and treatment if you have treatment there, if this is recommended by your consultants. It's possible that you might not need treatment for some time. You really do need to do the tests/scan(s) in orer to get a full diagnosis and then taking advice of your consultants into account, decide how you are going to play it. An enlarged prostate can be a problem on it's own but can still contain cancer.

Just a couple of points, most men who are on Tamsulosin experience no trouble with it. I am one of them, haveing been on it for over 25 years. Many men with PCa exhibit no symptoms and it is found in many old men that didn't know they had PCa but died of something else. However, for some men where is was diagnosed late and had spread, death and leading up to it from PCa can be a really bad experience.

Edited by member 28 Apr 2023 at 15:45 | Reason: Not specified

Barry

User

Posted 28 Apr 2023 at 16:13

Given that going in to retention is potentially serious (requiring emergency treatment to avoid kidney damage and a lot of pain) and that has already happened to you once, you should probably not regard the Tamsulosin as just a "nice to have", but rather more something to help avoid an emergency situation arising again.

Tamsolosin has a very quick acting relaxing effect on the muscles of the prostate and internal urinary sphincter to help you pee faster, and a longer term effect of reducing the prostate size which also helps to resolve the issue.

There are other alpha-blockers such as Alfuzosin, Doxazosin, etc. You could look at those instead.

Another option would be to take a 5𝞪-reductase inhibitor such as Finasteride. These shrink the prostate in a different way, but take around 6 months to have full effect, and don't have the instant effect helping you pee faster (so you might need an alpha-blocker too initially at least). A side effect to be aware of is that 5𝞪-reductase inhibitors will halve your PSA without changing your prostate cancer risk, so you have to double your PSA readings to assess prostate cancer risk.

Regular Tadalafil also shrinks the prostate over time.

There's also the surgery option of having a TURP or HoLEP procedure. That may become necessary eventually anyway if the medications can't sufficiently resolve the issue.

Edited by member 28 Apr 2023 at 16:14 | Reason: spelling

User

Posted 28 Apr 2023 at 17:56

I’ve been on Tamsulosin for four years, since my prostate cancer treatment, and it works miracles for me. Completely eliminates the “hard to pee” issues. Might I enquire why you’re reluctant to take it?

Best wishes,

Chris

User

Posted 28 Apr 2023 at 20:55

Ditto Chris, never had any issues and it's helped a great deal with starting.

User

Posted 29 Apr 2023 at 02:02

Thank you all for chiming in. Very helpful! There's a lot of areas I don't know about (yet). So far my main source of information is this 'https://www.cancer.gov/types/prostate/psa-fact-sheet".

To answer Chris' question re my reluctance to take Tamsulosin (or any medication) - it's mostly because of my skepticism regarding 'standard' medical treatments and prescriptions. So far I always did better without them.

i.e. I was 5 years ago and out of the blue diagnosed with Diabetes 2. I got all kinds of medicine described, after lots of research I stopped all that and started a rather rigid low/no carb diet (now often called Keto). My doctors called me crazy and painted doom in colorful pictures. Alas this diet was and still is extremely successful. The same doctors now called me 'healed' - which of course I am not, I just keep it in check. Should I start eating again the usual carb rich diet, pizza, spaghetti, potatoes and some cake I'd be right back to very high glucose numbers.

I'm of course also on the look-out finding 'natural' remedies or whatever regarding my prostate problems - so far haven't found any. I'm not anti so-called school medicine, but my acceptance standard is a bit high for better or worse.

The document I quoted above almost suggests one might do better without doing PSA etc tests. I didn't ask for it but they'd it and here I am, I'll have to deal with it either way. Not to mention my family got overly scared and pushes me to do this and this and that ;-)

Anyway, I appreciate all your replies - keep it coming, please.

User

Posted 29 Apr 2023 at 11:16

I should think that most people are reluctant to pump chemicals into their system as there will be somebody who suffers adverse effects and it is by no means possible to predict with accuracy who and to what extent an individual will be affected. We have seen this with the Covid jabs for example, where sadly at the extreme a relatively small number of people have been affected so badly that they have lost their lives to mitigate the risk and consequences of catching the disease. Of a lesser magnitude some men suffer very severe side effects from the various forms of HT. That is why when there is a choice, a man is often given one initially that needs to be given again after 28 days rather than the version that lasts for 3 times that length which can be changed to the longer lasting version if the initial dose is well tolerated. As regards Tamsulosin, this has benefitted many men and can be stopped immediately at once if it produces a bad reaction, so not really a serious long term risk. Radical treatment to treat PCa presents a more serious risk, as for example a small number of men who have Prostatectomy or RT face potentially serious long term side effects that cannot be undone and require further mitigating treatment with various degrees of success. The potential risk of radical treatment is therefore of a different magnitude.

I seldom take pain killers unless I am really suffering as for example with an infected or removed tooth when it has certainly helped. I do know some people who rush to the pill box at the slightest sign of a headache though. To me it's a question of degree. Also, inevitably, in general some drugs are much better than others in achieving what they are taken for and work better for some than for others. It is the case that longer life span owes much to various drugs that so many rely on in latter years.

Barry

User

Posted 29 Apr 2023 at 11:56

I took a PSA test 6 years ago as part of a routine health check and had an elevated result. Had an MRI, which showed no indications of cancer but did show an enlarged prostate. No treatment needed for enlarged prostate at that time. Was offered a prostate biopsy to check for cancer immediately after the MRI, which I declined on the basis of the MRI results and because I didn't want unnecessary interventions. Continued for the next 6 years to have regular PSA tests, which varied year to year but slowly but surely kept creeping up - say 0.5 increase each time. Then 12 months ago I had one incidence of blood in my urine; more tests but no prostate MRI offered and cause of blood in urine not determined; I was discharged by the consultant. 6 months later PSA again slightly up (6.0) on previous result. This time my doctor and I insisted on an mpMRI - the result of which was reported as 1 suspicious lesion, likely to be cancer. I got a second opinion on the same mpMRI images - result was reported as 3 suspicious areas, likely to be cancer contained within the prostate. I elected to have a biopsy, which confirmed cancer present in all 3 areas.

My points are this.

If you don't have an MRI you only have PSA results to go on, and these are indicators only, they are not conclusive.

Can you walk away now from further tests or will you forever have that nagging thought in you mind that maybe something serious is happening?

You can make a better informed decision after an MRI when you have more information, and you can choose then to have or decline further tests and treatment.

In my case I've now chosen to have treatment for prostate cancer. At 71I want to give myself the best chance I can of having quality of life for as long as I have time remaining and I don't want to wait until I regret not acting sooner.

User

Posted 29 Apr 2023 at 14:23

Keenast, at the age of 69 you have a roughly 70% chance of having prostate cancer - it's just a part of the aging process for a man, and virtually every man has it if he lives into his 80s.

A PSA of 12 is a clear sign that investigation is required; if you do have prostate cancer then with that level of PSA it's highly likely to be localised and treatable with curative intent. Nobody's going to force you to be treated, but would it not be sensible to go through the diagnostic procedures so you know where you stand and can make an informed decision about treatment?

Best wishes,

Chris

User

Posted 02 May 2023 at 10:58

Thank you again to all for your replies and thoughts. I decided to undergo an mpMRI screening and I'll see what's coming out of that. Maybe something good ;-)

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