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Best Prostate Cancer Treatment Options If You Have BPH Symptoms?
Prostate Cancer | Last Active: Feb 12 5:02pm | Replies (61)Comment receiving replies
I saw this thread bumped and thought I'd give an update. 2024 was a strange year. My second biopsy found no cancer and the second MRI found no change in the size of the existing cancer lesion that was found previously in the first MRI and biopsy. So how is that possible? Most likely the lesion is small enough that the sampling from the second biopsy just didn't happen to capture any cancer cells. Good news for sure. I was relieved and Mayo said I could go 3-5 years before another biopsy. Awesome. However...
My PSA number in Jan 2025 came in high at 7.6. I had a partial TURP surgery (the median lobe only) in the summer of 2024. That helped my BPH symptoms some, but since then I've still had some issues and started taking Tamsulosin again. So it's possible the higher PSA is from irritation due to BPH, or something else.
I meet with the local urologist next week. I assume they will recommend another MRI which I will do either at Mayo, or have Mayo read it if I have it done locally in my city. I'm still trying to figure out whether another BPH treatment will have to be done before undergoing radiation, if the next MRI and next biopsy show an evolution of the cancer to something that needs treatment. I've thoroughly researched the BPH treatments and am pretty sure I would do aquablation or HoLep if treatment is necessary before radiation for the cancer. Appreciate all the input.
Replies to "I saw this thread bumped and thought I'd give an update. 2024 was a strange year...."
One approach you might consider depending upon whether or not you actually have a cancerous lesion is focal therapy via TULSA-PRO procedure. I had this procedure done at Mayo Rochester in October, 2024. I had one cancerous lesion Gleason 3+4=7 and a 100cc prostate due to BPH. In this one procedure my doctor ablated the lesion and ablated 60% of my otherwise healthy prostate tissue. I'm approximately 4 months out from that procedure. He said once I heal I'll be peeing like a race horse..........and I am. So hopefully I've effectively killed two birds with one stone. I have my first MRI at Mayo in early April and my next PSA test. My 3 month PSA test my PSA dropping from 12.8 to 1.3. Since I still have a 40cc functioning prostate I would expect a PSA value. A value of 1.3 so far is well within the normal range. So far, so good.
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@dbee I would highly recommend a 2nd or 3rd opinion of your 1st Biopsy Gleason Score ( Pathology Report ) John Hopkins comes to mind . They likely missed the target area on your 2nd Biopsy . Have you discussed Dutasteride with your Urologist to address your BPH problem
My 1st Biopsy was negative . My MRI PI-RADS Score was a " 5 " . In complete conflict with a negative biopsy . My 2nd Biopsy , supported by a 2nd & 3rd opinion of the results nailed down my gleason score -- Four Cores Gleason 3 + 3 = 6 , Two Cores Gleason 3 + 4 = 7