BPH

[livingwith]

When I first began to research BPH the Urology Channel served as an important resource. I was dismayed by the many discouraging posts. My symptoms mirrored those of many of the posters, and I had been living with this problem for about 5 years. My symptoms were severe, with occasional flare-ups that made life miserable for both me and my wife. I was up three or four times a night, and tired all the time. It had become a major focus of my life. I was convinced that my only option was some ...Read the full article

[GenesisJohn]

I wanted to post a follow up to my previous post:

Although BPH symptom-free and enjoying life for the first time in years, a routine follow up PSA showed a number of 6 and a disconcerting free psa - psa relationship. My psa has been 6 and change for four years, and the (relatively) high number always attributed to BPG and recurrent bouts of prostatitis.

My urologist recommended a biopsy, and the results showed early state cancer, Gleason 6. I had two lobes affected, and a third had suspicious tissue. The samples taken showed cancerous cells in < 5% from one lobe, and < 10% in another, all three suspicious lobes on the same side. Samples from the other three lobes showed no cancerous cells.
I agreed to a Lupron injection, and started on another quest. My Urologist recommended Brachytherapy, and my potential survivor rate was in the high 90's. I am sexually active and have a much younger wife, so quality of life was (is) a big priority. The Lupron did not affect my sexual ability at all, but it very much did affect my sexual interest. The only other side effect I experienced was annoying hot flashes.

Of the cancer removal solutions I found, the proton beam therapy used at Loma Linda in California and MD Anderson in Houston was the least invasive, but required long stays away from home, 9 weeks for Loma Linda, 8 at MD Anderson. The treatment is only 15 minutes daily, and there are close to zero side effects.

Surgery was not an option for me, the quality of life risks were too great and my early stage cancer didn't seem to necessitate any urgency.

I could have gotten into any number of HIFU trials currently running around the country, and this seems to be an up and coming treatment, used in Europe for quite some time. However, my prostate was too large to qualify for the trial. This would have probably been my preference had I qualified. I might mention that those with money CAN be hifu'ed, the operation takes place outside of the US, Canada, Europe, Mexico with an American Urologist doing the procedure, but your insurer will probably not cover the cost. Long term results of this treatment are not available, but the results that are available are very favorable. If you were planning a long European vacation, this might be an option for you.

I'm convinced that HIFU will be available in the US within the next couple of years, and it's also touted as a salvage therapy for failed Brachy, so I felt that I still have a fall back if the cancer re-occurs after the Brachy.

In the end, after talking to a number of people, both professional and patients, I realized that my original Urologist's recommendation was on target. He worked with an experienced radiation oncologist who I immediately liked and respected. The Urologist scheduled a TUMT to reduce prostate size prior to the seeding, which I tolerated well, and my LUTS improved even more, to the point where I no longer have to take the alfluzosin. My wife became really sick of hearing "Listen to that! Like the proverbial race horse".

Had I known that I was going to respond so favorably to the TUMT, I would have chosen that initialy over the medication route. I still take the 25mg of sildenafil every morning, it keeps my blood pressure right on the money and opens up the pipes. I still take the dutasteride (Avodart), hoping for some prostate volume reduction. I also take the 400 IU of vitamin D and the 200 Mcg of selenium that I began some time back to avoid the prostate cancer (Google SELECT trial).

At the "Volume Study" to map my prostate prior to the seeding, the Radiation Oncologist found prostate tissue expanded into the bladder neck, and felt the prostate should shrink still more prior to seeding (prostate volume was 60). Now I'm on another quest to determine how that tissue can be most easily removed. It can't be seeded,, and even though the chances of it being cancerous are small, who wants to take the chance? I have the luxury of being able to wait for the optimum conditions.

I thought I would be done with this by Christmas of 2008. I still may. I like the idea of keeping my prostate, and the Radiation Oncologist says I will recover some prostate function over time, after the seeding. I'm old fashioned in this respect, I'd like to die with as much of my body intact as possible. I have a 89 year old mother in good health, so these decisions will have long term consequences for me.

I'll post a follow up when all is said and done. To summarize, my LUTS are gone. Life is good. Removing the obstructing prostate tissue in the bladder outlet may well improve things even more, and help insure a long term favorable prognosis. I still think Brachy is the way to go for my early stage cancer, and I'm going to stay on that track.

John

[jctnc1111]

Do you get blurry vision and/or headaches with the sildenafil citrate 25 mg daily . cialis has a low dose daily tablet. Could it be substituted. Where can i get more info on using as bph RX.

jack