Enlarged prostate size..

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gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 2/5/2010 7:40 AM (GMT -6)   
Sorry for not getting my signature filled in....just to recap, my father was diagnosed in Nov 09 with Stage 3 (seminal involvement) and Gleason 9 & 10. No other spread detected at that time. Was put on Casodex then Lupron. Recent PSA tests haven't told us much due to the fact that he has had a couple of urinary infections. He had a PSA of about 5 a few weeks ago (the highest, before hormone therapy, was 11), but again, it was taken right in the middle of the infection...

So right now the situation is that if anything, it seems like the prostate may have gotten bigger, and is pushing against the bladder, and causing a lot of pain. Ultrasound shows the size to be roughly 7cm x 5cm x 8cm.. (based on what measurements others have posted, I'd guess the weight would be somewhere around 95 grams). I'm not sure what the original size was a few months ago, but everyone who has examined him commented that it was very big.

He is scheduled to start radiation in about 8 weeks. But we are thinking the hormone therapy may not be shrinking it at all, and are not sure it is a good idea to wait that long for the radiation. Also wondering if, even though it has spread to seminal vesicles, it would be a good idea to have it removed (along with the vesicles)??
We did ask the urologist about adding proscar to see if it would bring the size down, but he said with the gleason score, and the fact that all biopsy cores were positive, the proscar would have nothing there to work on (since it is all cancer)...

Any advice appreciated!

Post Edited (gibson00) : 2/5/2010 5:51:09 AM (GMT-7)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 2/5/2010 12:51 PM (GMT -6)   
Waiting 8 weeks will not be a problem. The Lupron and Casodex should stop any growth and reduce the prostate size significantly. This will make radiation much more effective and reduce any damage to surroundng tissues because the prostate is smaller. I don't know if Proscar will help in shrinking the tumor, but it shouldn't hurt anything if it is used. In other words there is no downside to using it and there may be some upside in getting futher shrinkage.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 2/5/2010 1:14 PM (GMT -6)   
Thanks. I guess we were concerned that he has already been on hormone therapy for about 9 weeks, and if anything, it seems like it might be bigger than before...
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