1. < Prostate Cancer

Best Prostate Cancer Treatment Options If You Have BPH Symptoms

Posted by dbee @dbee, Jan 25 10:29am

I've been on active surveillance for two years. I also have some BPH-like symptoms and take Flomax for it. I may need to get treatment for the cancer. I do a biopsy next month.

I'm Gleason 3+3, 1 core positive, PSA under 4, low Decipher, but there's a chance it has worsened. The MRI showed the lesion is larger and my BPH symptoms have gotten slightly worse. Prostate size 66 cc.

In the event I do need treatment, I know surgery would address both the cancer and BPH symptoms, but am very reluctant to go that route because of the higher incidence of incontinence as compared to radiation.

But if I go with one of the radiation options, such as SBRT, IMRT, brachytherapy, or Proton, I'm worried that it will worsen the BPH like symptoms. And if it does, what do people do? Of course, there's also the possibility that the symptoms could improve, but it is my understanding that is difficult to count on happening with radiation.

Thoughts from those who had BPH like symptoms when they went into radiation treatment?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

ftd3 | @ftd3 | Jan 29 11:22am
In reply to @scottbon "Look into the HOlep procedure for BPH. I've had BPH for about 20 years and took..." + (show)
@scottbon

Look into the HOlep procedure for BPH. I've had BPH for about 20 years and took Flomax. 2019 was diagnosed having prostate cancer and been on hormone treatment Lupron. I researched BPH treatments but previous medical plan doctors wouldn't touch it because of the cancer. After switching medical plan and doctors I met with several urologist on best treatment for my BPH. They ultimately concluded HOlep (holeum laser embolism of the prostate}. Procedure is using a laser to core out the prostate of tissue surrounding the urethra and bladder taking pressure off the area and allowing normal urinary function. No surgery. All done through the penis. Excellent statistics with less than 1% incontinence. Outcome was 100% excellent with full relief and normal urination finally. Wish I had this done 20 years ago. Only issue was the catheter required for about a week. I'm 77. Check it out.

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Thank you for your comment about the HOlep for BPH. I was not familiar with it and will look into it. Were you put to sleep for the procedure? I have a really large prostate at 123cc which limits some BPH treatments. Thanks.

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1 reply
dbee | @dbee | Jan 29 11:51am
In reply to @vshirley "Finished 5 day sbrt 1/5/24.Take 1 flomax nightly,but am having to urinate just about every hour..." + (show)
@vshirley

Finished 5 day sbrt 1/5/24.Take 1 flomax nightly,but am having to urinate just about every hour after going to bed around 11pm.

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did you have BPH before treatment?

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2 replies
dbee | @dbee | Jan 29 11:55am
In reply to @scottbon "Look into the HOlep procedure for BPH. I've had BPH for about 20 years and took..." + (show)
@scottbon

Look into the HOlep procedure for BPH. I've had BPH for about 20 years and took Flomax. 2019 was diagnosed having prostate cancer and been on hormone treatment Lupron. I researched BPH treatments but previous medical plan doctors wouldn't touch it because of the cancer. After switching medical plan and doctors I met with several urologist on best treatment for my BPH. They ultimately concluded HOlep (holeum laser embolism of the prostate}. Procedure is using a laser to core out the prostate of tissue surrounding the urethra and bladder taking pressure off the area and allowing normal urinary function. No surgery. All done through the penis. Excellent statistics with less than 1% incontinence. Outcome was 100% excellent with full relief and normal urination finally. Wish I had this done 20 years ago. Only issue was the catheter required for about a week. I'm 77. Check it out.

Jump to this post

what is your cancer situation? Did you have it treated? Which procedure?

REPLY
1 reply
scottbon | @scottbon | Jan 29 12:02pm
In reply to @ftd3 "Thank you for your comment about the HOlep for BPH. I was not familiar with it..." + (show)
@ftd3

Thank you for your comment about the HOlep for BPH. I was not familiar with it and will look into it. Were you put to sleep for the procedure? I have a really large prostate at 123cc which limits some BPH treatments. Thanks.

Jump to this post

Yes. It's an inpatient hospital procedure with anesthesia. Prostate was greater than 100cc. I think it is the best safest BPH treatment. It's been 6 months and urination completely restored to normal. Check with an Urologist if best for you.

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vshirley | @vshirley | Jan 29 1:42pm
In reply to @dbee "did you have BPH before treatment?" + (show)
@dbee

did you have BPH before treatment?

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No I did not.

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ftd3 | @ftd3 | Jan 29 2:19pm
In reply to @scottbon "Look into the HOlep procedure for BPH. I've had BPH for about 20 years and took..." + (show)
@scottbon

Look into the HOlep procedure for BPH. I've had BPH for about 20 years and took Flomax. 2019 was diagnosed having prostate cancer and been on hormone treatment Lupron. I researched BPH treatments but previous medical plan doctors wouldn't touch it because of the cancer. After switching medical plan and doctors I met with several urologist on best treatment for my BPH. They ultimately concluded HOlep (holeum laser embolism of the prostate}. Procedure is using a laser to core out the prostate of tissue surrounding the urethra and bladder taking pressure off the area and allowing normal urinary function. No surgery. All done through the penis. Excellent statistics with less than 1% incontinence. Outcome was 100% excellent with full relief and normal urination finally. Wish I had this done 20 years ago. Only issue was the catheter required for about a week. I'm 77. Check it out.

Jump to this post

Thank you for your quick reply! Take care.

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vshirley | @vshirley | Jan 29 2:53pm
In reply to @dbee "did you have BPH before treatment?" + (show)
@dbee

did you have BPH before treatment?

Jump to this post

Did not have BPH before treatment.

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vshirley | @vshirley | Jan 29 3:08pm
In reply to @busyyaya "Same for my husband post radiation 12/26 (last session) , the frequency has gone to every..." + (show)
@busyyaya

Same for my husband post radiation 12/26 (last session) , the frequency has gone to every 2 hours from hourly. When up every 3 hours. And he’s gotten to every 2 days on Flomax as it was making him dizzy, seems to help. My guess is urethra was hit near prostate and swollen so not completely emptying bladder each time. Swelling must be coming down as frequency becomes less and burning with urination improves. Hang in there.

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Thank you so much that is very encouraging.Taking last flomax tonight.Have not had burning with urination.Godspeed.

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vshirley | @vshirley | Jan 29 3:24pm
In reply to @busyyaya "Same for my husband post radiation 12/26 (last session) , the frequency has gone to every..." + (show)
@busyyaya

Same for my husband post radiation 12/26 (last session) , the frequency has gone to every 2 hours from hourly. When up every 3 hours. And he’s gotten to every 2 days on Flomax as it was making him dizzy, seems to help. My guess is urethra was hit near prostate and swollen so not completely emptying bladder each time. Swelling must be coming down as frequency becomes less and burning with urination improves. Hang in there.

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This is very encouraging.Last flomax tonight.Have not had burning during urination.Thank you very much.Godspeed

REPLY
scottbon | @scottbon | Jan 29 7:48pm
In reply to @dbee "what is your cancer situation? Did you have it treated? Which procedure?" + (show)
@dbee

what is your cancer situation? Did you have it treated? Which procedure?

Jump to this post

Routine physical March 2019. PSA 136. Urgent appointment with urologist but took 3 months to see doc. PSA 245. Biopsy and MRI confirmed cancer. Placed on hormone depravation therapy {ADT} 3 month Lupron injections. PSA dropped to 0.5. Doc ecstatic. Too much side effects and stopped 2021. Changed health plan and new doc. Back on Lupron with rising PSA. Last month added enzalutamide {Xtandi}. PSA going down. Main side effects are fatigue, muscle loss and weakness, hot flashes, dry skin, brain fog.

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