Anyone Taking Combined Therapy of Tamsulosin + Finasteride for BPH?

Posted by tgregg99 @tgregg99, Apr 15 7:58pm

I'm 72. I've been taking Tamsulosin (Flomax) for a year to treat my BPH (nocturia is my primary symptom), and I've responded well to the med, no issues.

However, because my PSA test results have also inched up above "normal" in recent years (although my free PSA test results were very high, on the good side) my urologist ordered a multipatametric Prostate MRI to see if there were any "areas of concern" (PC lesions). I just got my MRI results, and I have a visit scheduled next month with my urologist to discuss my results and treatment options.

The MRI results show no lesions in the central gland or peripheral zone of the prostate. But the PA said the MRI shows I have an enlarged prostate, so I it confirms what I've been led to believe this past year via my symptoms. I also learned my prostate volume is 97g, which appears very large to me.

Until I talk with my doc, I won't know his next-step recomendation, other than to continue with surveillance. But I'm guessing that he may want to add a 2nd med along with my alpha blocker to see if it could decrease my prostate. I know from our previous talks that he and I are in sync re: conservative treatment and avoiding unnecessary surgery if possible. I'll know soon perhaps what he recommends.

Sorry for my long story here, but I was wondering if anyone is currently taking
an alpha blocker + another med for BPH and if such combo is working to decrease your prostate size.

Thanks so much for your thoughts.

Best wishes!

Interested in more discussions like this? Go to the Men's Health Support Group.

My situation was similar to yours. I had an enlarged Prostate for 6 years; was on Flomax; my volume was 68 and my PSA was gradually rising. I had a biopsy and MRI 5 years ago. I had my second MRI which was negative of cancer. However, my 2nd urologist said that the MRI could only scan 80% of my prostate. I ended up having a biopsy, which showed two cores of 14 with cancer, one with G4+3. I had mine removed this past November. Pathology showed my core was actually G4+5. My first two blood tests showed my PSA at < 0.01. Hoping and praying for more of the same in the future. My biggest suggestion to you is to ask your doctor about the accuracy of the MRI. If you are unsure, get the biopsy. My urologists took the wait and see approach. As I look back I wish the urologists would’ve been more assertive earlier in my diagnosis. Best luck with your decision🙏.

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I appreciate your feedback very much, thank you. When I talk with my urologist, I will certainly ask him about the accuracy of the MRI, good advice. Best wishes to you!

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i advise you not to kick the can down the road.

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I deal with issues proactively ... I don't believe in kicking the can down the road.

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Taking Combined Therapy of Tamsulosin + Finasteride for BPH?

For those who've been taking both meds for awhile, are they working to improve your BPH symptoms? And for those who've stopping taking both meds, did your prostate return to "normal" with a decrease in symptoms and with an improvement in the quality of your life?

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@tgregg99

Taking Combined Therapy of Tamsulosin + Finasteride for BPH?

For those who've been taking both meds for awhile, are they working to improve your BPH symptoms? And for those who've stopping taking both meds, did your prostate return to "normal" with a decrease in symptoms and with an improvement in the quality of your life?

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Hi @tgregg99, I moved your question about taking the combined therapy of tamsulosin and finasteride for BPH (benight prostate hyperplasia) to the Men's Health support group here: https://connect.mayoclinic.org/group/mens-health-1/

I'm tagging some members who have experience with these medications like @wpasternak @garyinmontara @kayak461 @predictable @pablo81 @fredunger @paul55

Gregg, have you noticed any improvement since starting the combination therapy?

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@colleenyoung

Hi @tgregg99, I moved your question about taking the combined therapy of tamsulosin and finasteride for BPH (benight prostate hyperplasia) to the Men's Health support group here: https://connect.mayoclinic.org/group/mens-health-1/

I'm tagging some members who have experience with these medications like @wpasternak @garyinmontara @kayak461 @predictable @pablo81 @fredunger @paul55

Gregg, have you noticed any improvement since starting the combination therapy?

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Coleen,
Thanks so much for doing that. I wasn't receiving any responses to my post, but perhaps now i will, thanks to your effort. I appreciate your help!
About your question, yes, I have noticed some improvement. As I told my urologist recently, since starting Tamsulosin last year, my nocturnia (trips to the bathroom at night) have gone from 3-5/night to 1-2 now (mostly 1), which has been very manageable, no complaints. He was confident that I would benefit from adding the finasteride as a combined therapy to see if that will help decrease the size of my enlaged prostate. It takes time (6 months to a year for complete results I'm told). My urologist was optimistic. We'll see. So far, so good, and I'm not experiencing any "major" side effects from either med that I can't live with. But I have to give it more time, of course.
Thanks again!
Terry

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If it turns out you don't need surgery and can get by with radiation, I would suggest a PAE (prostate artery embolization). I had proton therapy which took care of my two tumors but still was on FloMax twice a day. The PAE that I had 18 months ago cured most of my symptoms. Normal flow but still get up 2-3 times per night. I'm 85 so that is somewhat normal for a bladder of my age. The PAE was a miracle for me as alpha blockers dangerously lowered my BP with any vigorous exercise (tennis). A urologist will seldom mention a PAE since it competes with their roto-router procedures. PAEs are done by the same doctors that put in stents. They went into my thigh, up into my aorta and then down to the two arteries going to my prostate and put small beads in them to block blood going to the prostate and therefore causing it to shrink. I was in and out in about 4 hours and was out walking my dog that evening. There was some minor pain urinating for about a week.

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@tgregg99

Coleen,
Thanks so much for doing that. I wasn't receiving any responses to my post, but perhaps now i will, thanks to your effort. I appreciate your help!
About your question, yes, I have noticed some improvement. As I told my urologist recently, since starting Tamsulosin last year, my nocturnia (trips to the bathroom at night) have gone from 3-5/night to 1-2 now (mostly 1), which has been very manageable, no complaints. He was confident that I would benefit from adding the finasteride as a combined therapy to see if that will help decrease the size of my enlaged prostate. It takes time (6 months to a year for complete results I'm told). My urologist was optimistic. We'll see. So far, so good, and I'm not experiencing any "major" side effects from either med that I can't live with. But I have to give it more time, of course.
Thanks again!
Terry

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Hello tgregg99! I did take Tamsulosin and Finasteride as prescribed by my Urologist in the VA for BPH! I think the length of time was 7-8 years. The problem I have in explaining my perception of its effect on my enlarged prostate! My enlarged prostate eventually grew upwards and into my bladder, to a size that eventually led to urine retention. Tests confirmed the need for prostate surgery…..I chose HOLEP for the solution. I would say that Finasteride didn’t reduce the prostate size as it was eventually removed anyway. But…..perhaps it slowed its growth! This is my opinion only, not a doctor’s! Hope this helps you!

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@kayak461

Hello tgregg99! I did take Tamsulosin and Finasteride as prescribed by my Urologist in the VA for BPH! I think the length of time was 7-8 years. The problem I have in explaining my perception of its effect on my enlarged prostate! My enlarged prostate eventually grew upwards and into my bladder, to a size that eventually led to urine retention. Tests confirmed the need for prostate surgery…..I chose HOLEP for the solution. I would say that Finasteride didn’t reduce the prostate size as it was eventually removed anyway. But…..perhaps it slowed its growth! This is my opinion only, not a doctor’s! Hope this helps you!

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Hi kayak461,

Thanks so much for your response, it's very helpful to me at this stage of my journey. I'll keep your info in mind as I go forward.

Best wishes to you!

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