BPH & Cancer Information

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Hello all. I have been doing a lot of reading about BPH and Prostate Cancer. Some may find this boring and some may what to know. I find it very interesting.

Male urinary problems have been around for every. But could not be diagnosed because they did not have the test we have today. They were never able to say what it was until the patient died. Many men with urinary retention were treated with catheters. Surgery is a product of the last 100 years.

Jean Riolan in 1649 was the first to suggest that a enlarged prostate could cause urinary retention. At that time there was little medical interest in a enlarge prostate until the 18 th century. Doctors sought means to carry a cutting or a piercing tool around with them because they new that if a man went into retention that this would make a new channel. Can you imagine the pain these men have to go through. I feel very sorry for them.

A doctor in 1756 passed a lance shape stylet through a open end catheter through the median lobe of this older man. He lived 10 years. After he died the doctor found out that the prostate was enlarged and what he did 10 years earlier made a tunnel so the man could void. This procedure was done by some of the other doctor of that time and all patients died. ( I guess what they said counts. You need to find a good doctor )

In 1830 a procedure was done to remove a stone. When he was taking out the stone some of the tissue got caught in the forceps and was removed. He found out that the man was able to void much better. This was a accident and removing the tissue was not done for BPH. It was only use if a stone had to be removed and at that time they saw a blockage.

Doctor's have been going on like this for years to see what would be the best way to take care of BPH.

This one was really out there and was done on over 400 men. In the 1900's doctor felt that vasectomy and castration would be good for BPH. It did help a few. But the procedure were dropped because it did not catch on. I wonder why.

I could go on but I will try to wrap this up. In 2018 we have many procedure some have just come up over the last 10 years. We have many options to pick from. Much better then 300 years ago. It is up to the man to research the procedure that he is being told that would help his problem. Not all procedures work for all men. Also you have to see what side effects come with the procedures and what you can live with. Do your pros and cons. We all have different concerns.

Also talk it over with your wife or partner because any procedure you have is going to affect them. They are going to be there for you. That is the way it should be.

Now I only have a couple of things to say about Prostate Cancer. This was a very good article. It was called * Know your grade *

If you are told you have prostate cancer. Do not rush into any procedure. The side effect from surgery are from mild to extreme. Erection and pain with orgasm. To total loss of erection and incontinence. It is impossible to predict. That is why this doctor said. Knowing your stage and grade will help you. Staging provides insight into your treatment. Mild cancers deserve mild treatment. Aggressive cancers require aggressive treatment.

Suffering from treatments related to side affects as incontinence and sexual dysfunction is unacceptable if the cancer is mild. If it is life threatening then surgery is justified.. Most cancers are slow growing and can be watch for years. Most of the time it take 10 years for it to cause you a problem. He also said most of the time men died from something else other they prostate cancer.

I hope 2019 brings us hope and good health...........God Bless us all......Happy New Years.................Ken

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  • Posted

    I was talking to a fit Guy of 85 today who has PC that is confined to the prostate capsule. It was first diagnosed in May. The NHS told him that they do not operate after the age of 73 unless it has spread. He is on a lot of medications.

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    • Posted

      Hey Derek

      You read that a lot. When you get prostate cancer most of the time if you do not have 10 years left they will not do surgery. At 85 you never know he may live to a 100.

      All they will do is medication and watchful waiting.

      For me If I make it to 85 I would just live my life and enjoy my self. Reading the article of what men had to go through years ago. We have it good.

      Hope you had a good Christmas And have a Happy New Year...Ken

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    • Posted

      I agree. It is very unwise to operate on anyone at that age unless a life is in the balance. While a biopsy or MRI may indicate a cancer is confined to an organ ie the prostate, that is not always the case as surgery may reveal otherwise.

      That said, I would not even recommend medications until there was evidence of the PSA rising.

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    • Posted

      Good Morning Barney

      Yes I do agree that if the cancer is still in the prostate watchful waiting is the way to go. Why have a surgery if you don't need it right away.

      I don't know what med's they would give you but I have read that they want you to change your diet.

      Have a great New Year.....................Ken

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  • Posted

    Thanks Ken for a very informative posting!

    I know the prostate cancer scare very well having been "diagnosed" now 3 times by urological testing only to be cleared by multi-parametric 3T-MRIs. Urologists are very quick to assign prostate cancer to high PSAs without any regard to BPH. Most screening tests for PCa are designed for men with normal size prostates so those of us with BPH should ask key questions about any screening tests if they are also validated for BPH patients. I had multiple blind trus needle biopsies over the years because my PSA was elevated due to my large prostate. These biopsies caused endless agony for me and when they always came back normal my stupid uros would say - "well, there must be cancer in there some where and we just missed it".

    Prostate cancer at the cell level is not a problem. It is only when it becomes clinically significant in the form of lesions seen on MRIs that it is even worth doing a targeted biopsy. And now there are several good focal procedures for removing the cancer which leaves the prostate and all its support stuff intact.

    The old school was to just remove the whole gland just like they use to remove entire breasts at the first sign of a cancerous lesion. All that now belongs in the dark ages if the cancer is still contained in the capsule and caught early.

    For us BPH guys the best screening is still the good old DRE as well as a dynamic contrast MRI if warranted. Also monitoring PSA density and FREE PSA is helpful.

    Urologists think that BPH can cause prostate cancer because of the increased cell proliferation which increases the chances of mutations but there has been no data to back that up.

    All the best for 2019! Let us know about jimjames - I miss him very much. Howard

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    • Posted

      Hey Howard

      I am with you on the needle biopsies. I would never do that again. I had one back in 2002 when I was 47. My GP told me my PSA was 426. She told me I had prostate cancer and had to see a urologist. At that time I did not even know what a urologist was. I thought it was a head doctor. You can say wrong head.

      I had every test they had back then and a 12 needle biopsy. It turned out to be a very bad prostate infection. I had a lot of pain for a few day's. And the first time after I had sex after there was a lot of blood and it hurt like you know what.

      We have come along why. I feel sorry for the men of yesterdays. Now we should not rush into any surgery. I was very happy that I read that article. Know your Grade. It can put your cancer in perspective. But that is up to the man to decide.

      Yes that is true that BPH does not cause cancer they say the same about prostatitis. But there are no facts.

      If I hear from Jim I will let you know it has been about 5 or 6 weeks.

      Happy New Years.......Ken

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  • Posted

    Thanks Ken ,

    You highlight some very important stuff.

    My step dad had prostate cancer for 15 years and opted for hormone injections which kept it in check and he died with it NOT of it .

    We are all different as you high lighted . Some men would rather have surgery to get it out ( i suspect i would fall into that catagory ) even though it may never cause an issue . ive been down the pub tonight with a friend who is suffering constantly from BPH and its ruining his life. No one had explained to him that CiC is an option or indeed had offered any surgery . He is not bothered by RE because of his age but as a typical Brit had not told his Gp how much it was affecting him . His Gp had put him on Tamusin years ago which is no longer working for him . In the Uk typically older people dont push and assume their Gp is God . This forum educates and opens up our eyes to the options available .

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    • Posted

      No problem

      I found it very interesting when men had to do years ago for the same problem. Most men just listen to there doctor and do not realize that there are options. The 2 articles I would say to read are * Know your Grade & I want my prostate back.

      Most prostate cancer is slow growing and can be kept in check with medication and watching it. Like your step dad 15 year. Who know how long he would have lasted if he would have had the cancer taking out. I don't know if anyone ever heard this before. When I was much younger let's said 50 years ago. I heard if you have cancer leave it alone do not have surgery because once it hit the air it will grow very fast.

      That happen to a lady next door to me. She was in her early 50's had cancer of the lung. The doctor said that it was a small tumor. And the doctor told her and her husband that he could get it out no problem. She had it and was dead within a month

      By the way did you tell the guy to try CIC to see if it would help him or at least talk with his doctor

      Take care my friend Happy New Year.................Ken

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    • Posted

      Hi Ken

      i certainly did suggest my pal tries CiC and in view of his problems and no concern for RE I also asked him to get referred to a Urologist as i think he's someone that would benefit from surgery , maybe even a TuRP. Hes very old school though and will only act on his doctors advice .

      Take care mate

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    • Posted

      Good Morning.

      Yes he need to see a good Urologist

      But I would not want anyone to have a regular Turp to many side effects. And with a man that is older he may not heal as fast. Maybe something with Laser would be better for him. He need to be tested and see what would help

      Keep on him. Help when you can.....Ken

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  • Posted

    I was told that my PSA level was way too high (10) on my last medicare check-up. My GP seemed worried and told me that we would have to try more antibiotics as we did about a year before with my prostatitus. I'm not sure now why he thought this could bring down my PSA level because I hadn't had a UTI for several months before the blood test. I don't know, does a UTI increase the PSA level? I think there is a connection. So he told me it was either the A/B or he would order a biopsy. He said that when the PSA level gets over 10 they begin to worry about it spreading to other organs. I did the 2 weeks of the pills and it did seem to lower it to about a 7. I am living now under the assumption that doing cic about 4 times a day is what is irritating my prostate cause the rise in PSA level. Many people on this forum say PSA is not a good indicator of prostate cancer. Reading these posts makes me wonder how all of you who know you have PC found out the diagnosis for sure. Do you have to have a biopsy?

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    • Posted

      Keith

      They did the same to me when I was 47. My GP told me my PSA was 426 ( Yes 426 still have the paper work )

      I had to have all the test that they had back in 2002

      The last one was a 12 needle biopsy After going through that mess It turn out to be a prostate infection. I may have to look it up again but I think if you have a prostate infection your PSA can go higher because the prostate is inflamed. I just look and that is a yes a infection can raise your PSA.

      I also just read that age has a lot to to with a normal PSA number. A normal PSA for someone in there 40 is different then a guy in there 60

      Just continue doing what your doing and just make sure every thing is clean so you don't get a infection.

      Take care Ken

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    • Posted

      Hi Keith,

      YES - doing CIC will elevate your PSA levels for various reasons but it doesn't harm your prostate. You should NEVER get your PSA checked within 12 hours of doing CIC. A few weeks ago my PSA value was 47 just 4 hours after CIC but then a week later it was 22 when I waited 12 hour. Urologists have no idea about this and just freak out. And with my 300 cc prostate my PSA density was so low it was ridiculous.

      For us BPH guys here are the best ways to screen for PCa:

      1. DRE 2. PSA density 3. FREE PSA (values done 12 hours after any self-cath 4. mp 3T-MRI
      2. If any thing suspicous shows up then only a targeted needle biopsy of a visible lesion should be done.

      AVOID blind needle biopsies and liquid biopsies as they are calibrated for normal size prostates

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    • Posted

      Hi Keith,

      For those of us with enlarged prostates the PSA level is not a good indicator of possible prostate cancer because the prostate gland produces PSA so the larger it is the more PSA it will produce that gets into the bloodstream. So in your case you need to take the PSA value and divide it by the prostate size in cc. This gives the PSA DENSITY which is one of several indicators of possible PCa. You want your PSA Density to be less than 0.1 for a good value.

      In my case my prostate size is 300cc and my PSA value is 26. So my PSA density is about 0.08 which is a good value. My urologists just freak out when they see a value of 26 and want to do all sorts of saturation needle biopsies so I have to educate them about BPH as they deal mostly with cancer patients that have normal size prostates.

      Another good indicator is the FREE PSA which you can ask for when you get your PSA blood test. It is also measured in the blood. When prostate cancer is present this value is low ( less than 18%) because the cancer cells use the free psa as fuel to grow so there isn't very much in the bloodstream. Again in my case my value was 38% which is very good.

      I finally agreed to a mp3T-MRI to check for any clinically significant cancerous lesions and my MRI was clear which left my urologist scratching his head since my PSA value was so high. He finally just said "there must be cancer in there somewhere" to which i responded "maybe" but if it is just at the cell level and has not grown into tumors then I probably have another 100 years till I have to worry. He just growled at me!! Take care. Howard

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