Finesteride

With Gleason of 3+3 you may be able to have active surveillance and delay treatment, possibly indefinitely, your consultant will let you know.

If you have urinary retention finasteride is an appropriate drug. It has a side effect of reducing PSA. I don't know if it changes prostate size.

There is no point in taking any drug with the purpose of reducing your PSA, because reducing PSA does not cure cancer. It would also make Active Surveillance much less reliable, ultimately increasing your chance of dying from cancer.

If you don't want to see or hear high PSA figures then closing your eyes and putting your fingers in your ears when they are mentioned would be a better approach than taking drugs to make them less meaningful.

Finasteride will halve your PSA, but has no effect on prostate cancer, so you will need to double your PSA test results to assess risk/progression of prostate cancer. It is a half-way hormone therapy drug, preventing the generation of DHT (Dihydrotestosterone) which the prostate prefers to use, without impacting Testosterone. Loss of DHT might impact libido and erections a bit (not as much as full hormone therapy medications). Hair follicles also use DHT - it causes both body hair growth at puberty and baldness (i.e. opposite effect in different hair follicles), so you might see some reversal of both these effects. Beard and pubes tend to be less impacted than other body hair although grow slower. Finasteride takes about 6 months to shrink your prostate as much as it's going to. Dutasteride works the same way.

Tamsulosin is also commonly used for enlarged prostate. It doesn't impact on Testosterone or DHT levels. It has two effects. Short term, it relaxes the prostate and internal urinary sphincter muscles, so you can pee faster and are more likely to empty your bladder when you pee. Over a long term it also shrinks the prostate not as effectively as Finasteride, but its benefit is more immediate.

Hi Marknotts , 

Thank you so much for your reply . The only problem I have is the amount of time it takes to pee , which his is why I initially went for PSA tests  . I was prescribed Finesteride but checked side effects on line which mentioned the possibility of aggressive cancer so steered clear,they also mentioned Tamsolusin which relaxes the muscles with no side effects . Not sure what to do now ! 

Hi Brent , 

Thanks for your reply  .  I've spoken to 2 different  nurse specialists , 1 said Finesteride and the other said Tamsolusin. Both had different side effects, so don't know what to do ! 

Good luck with your treatment . 

John

I have been okay on finesteride. Tamsolusin made me tired and exhausted all the time. Everyone will be different and unique. Good luck whatever you decide. Mark.

Last year I had a severe gastric bug, couldn't keep anything in or down. This resulted in dehydration (I did try to drink!) and a UTI with high Colony Forming Units of E.Coli. Doc put me on antibiotics, told me to watch for flank pain as the infection was severe.

Flank pain arrived, saw Doc again - 'Go to A&E NOW' (she suspected early sepsis).

A&E put my on IV Gentamicin antibiotic for three consecutive days. Because I wasn't peeing very well, they sent me home with a Catheter, which irritated my prostate and resulted in extreme urgency. I never actually pee'd myself but got very close!

Wen to see a urologist privately as we were due to be away from home for a few weeks. He suggested Finasteride in addition to Tamsulosin.

I took it for 6 weeks, but stopped when I started to grow a breast (just one!) - a known side effect of Finasteride.

I'm now 7 months post gastric issue that started all this, I get up once in the night (sometimes not even that), pee reasonably well, no urgency that can't be easily controlled.

I have 6 monthly PSA reviews due to a slight suspicion of area on an MRI scan. First read was PIRADS 2, second read was PIRADS 4! I had a biopsy but nothing found.

Had my PSA bloods done a couple of weeks ago, my 'virtual' appointmnet is this Friday! Fingers crossed!

So, my experience of Finasteride is bad, yours may be different (and I still have MOOB!)