Proscar Reduction of Prostate

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ShinytopPC
Regular Member


Date Joined Feb 2014
Total Posts : 86
   Posted 2/4/2014 10:03 AM (GMT -6)   
April 12, psa of 4. April 13, 4.35, November 13, 4.7. Age 65. Biopsy revealed 3 of 12 cores involved, max 15%, Gleason of 6 (3+3).

During biopsy Dr had to have a tech come in to enlarge the field of view of the ultasound. He estimated my prostate at 137 grams. Due to heart history he is hesitant to recommend robotic surgery with its 4 hour duration. He recommends AS with consideration of future open surgery or radiation. Either way he is recommending a turp and has placed me on Proscar.

Anybody have experience with proscar? How much reduction can I actually expect with it?

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3347
   Posted 2/4/2014 10:55 AM (GMT -6)   
Thankfully you appear to be low risk with the cancer. AS could be excellent for you and radiation would mean no surgery risk. Proscar and Avodart will both reduce your prostate, but the significance will vary among men. I have understood it will reduce your PSA by 35-50% over several months. With he apparent low tumor volume most of your PSA appears to be from your prostate so it could reduce in size significantly. Let's hope so.

I wouold also ask your doctor about Jalyn. It combines Avodart with Flomax. Avodart has shown to be stronger and more effective than Proscar. Combining Avodart and Flomax (Jalyn) showed in clinical trials to be more effective than using them alone.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 and Testosterone less than 3 since February 2011

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8602
   Posted 2/4/2014 12:18 PM (GMT -6)   
Welcome ShinytopPC and sorry about your Dx. That is one whopper of a prostate! It seems to be interfering with your urination, which is why your Uro is recommending a TURP. A TURP now does complicate some of your treatment options later. Nerve-sparing surgery may be more difficult, and seeds will be impossible. But that still leaves you with SBRT, HDR brachytherapy, IMRT or proton.

There is a long-running thread on this site about the "Gat Goren method," that you may be interested to learn about (put it in the search bar). Laser TURP is increasingly popular over surgical TURP.

I have little to add over JNF's excellent response, other that Proscar has been known to shrink tumors in men who are on AS. As it shrinks your prostate, it will improve the diagnostic ability of the PSA test and make any cancer easier to find.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 6 year results
treated 10/2010 at age 57 at UCLA
•PSA since treatment:
1/11:3.9 5/11:3.0 8/11:3.7 5/12:1.2 9/12:1.3 5/13:0.4
• SEs of treatment:
after 2 wks: mild urinary & rectal - last 1 wk
1 yr after: mild urinary - last 2 months
no ED

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3347
   Posted 2/4/2014 2:03 PM (GMT -6)   
I'm thinking it might be a baseball!   Regarding a TURP, you might also ask about the GreenLight Laser treatment.   Supposedly increased effectiveness with less side effects.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 and Testosterone less than 3 since February 2011

Break60
Veteran Member


Date Joined Jun 2013
Total Posts : 1743
   Posted 2/4/2014 3:13 PM (GMT -6)   
Dear Shiny

Didn't you have any symptoms of BPH with such a large prostate? As others have said, gleason 6 is really good news and you should be a candidate for AS. I took proscar (finasteride generic) for ten years and my prostate was only 33 gm when I was dxed with gl9 PCa.

I have no idea how fast it shrunk and I didn't care; my primary interest was relief from BPH symptoms, and it worked, along with tamsulosin. Just be aware that your PSA needs to be adjusted to about double the actual reading as proscar cuts PSA about in half also.
Bob
__________________________________________________________________________________
DOB January 1944
1981: prostatitis
2000-2013 BPH treated with finasteride & tamsulosin; low T treated with androgel
PSA History:
Pre 2009 0.4-.6
11/2011 2.2
8/2012 2.7
2/2103 5.5
4/2013 6.1
5/2013 6.6
11/2013 0.1
1/2014 0.2

6/2013 Bx:PCa Gleason 4+4=8 (Bostwick), 4+5= 9(Johns Hopkins), 2/6 cores, 10%, 40%, DRE neg. (Stage PT1c)
7/2013 bone scan and pelvic MRI negative
9/7/13 open RRP, Johns Hopkins, Ted Schaeffer MD PhD.
9/9/13 Pathology: 33G, both nerves spared, SVI, EPE and 4mm pos. margin at base (Gl7), Stage PT3bN0M0)
9/20/13 Foley and staples removed
Continence: one pad per day for 13 weeks, now none. ED pre and post op.
Watchful waiting until next PSA May 1, 2014

ShinytopPC
Regular Member


Date Joined Feb 2014
Total Posts : 86
   Posted 2/4/2014 6:29 PM (GMT -6)   
In 1995 I took prescription drug that swelled my legs to the point return valves below the knee were damaged. This required me to take furosemide to keep the legs from swelling too much. As with any diuretic it changes the way you pee as well as the urgency. So the symptoms that might be obvious to another were not in my case. Another symptom of BPH is having to get up in the middle of the night. That happens to me less than twice a month. So I did not know of my prostate size until the biopsy.

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8602
   Posted 2/4/2014 6:45 PM (GMT -6)   
Then what do you need a TURP for? The Proscar will eventually shrink your prostate without having to cut it out.

ShinytopPC
Regular Member


Date Joined Feb 2014
Total Posts : 86
   Posted 4/7/2014 9:08 AM (GMT -6)   
Dr is recommending Turp should I eventually decide to have radiation therapy. He says that swells the prostate so since I am already having signs of difficulty peeing the turp would be necessary.

Had my most recent psa appt with Dr today. It reads 2.2 which is a 4.4, a slight reduction from my last 4.7 in November. So I am staying the course for now with AS. Current plan is PSA and DRE in July. If everything stays the course next biopsy should be in December or January.
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