Finasteride

Posted , 22 users are following.

Just wondering if there are some men who can comment on this drug.  My Urologist wants me to take it to reduce the size of my prostate.  I have very mild bph symptoms.  I even sleep through the night without having to get up.  His concern is my psa score has gone up 2 points in 3 months.  I did a 3T MRI which shows no areas of concern.  So he gave me three options.

1) Do another psa in three months.

2) Do a biopsy to see if there is any sign of cancer.

3) Take Finasteride for 6 months to shrink the prostate so if the psa score continues to increase, the prostate is smaller and therefore less samples from a biopsy are needed.

I was in favor of the Finasteride as a smaller prostate would be nice and the Urologist said there were no bad side effects.  However, from what I have read, there are side effects that are not very appealing.

I am now thinking of just waiting to do another psa in 3 months but if the score continued to rise, I will need to make some decisions.  

Anyone with thoughts regarding my three options are welcome. Plus If anyone is taking Finasteride (or a similar product), I would like to hear your experience.

1 like, 41 replies

Report / Delete

41 Replies

Next
  • Posted

    I take finasteride to shrink my prostate. I don't have side effects from it maybe decessed libito. My prostate is ~ 120 cc but I pee pretty good. I'm not sure why your uro thinks taking it will help your PSA levels. Yes finasteride lowers your PSA by about half. I don't know if that changes your cancer risk though. I thought rising PSA MAY indicate cancer but I don't think a high PSA causes cancer. No way would I have a blind biopsie. It better be guided by ultrasound or MRI. If Iwasn't having trouble peeing I would not go on finasteride. You PSA  level is effected by a lot of things. Google it and avoid those things prior to your next PSA test. Has your uro measured your prostate?

    Report / Delete Reply
  • Posted

    Hi,

    My bph is a little worse than yours and I took Finasteride for 6 months. It didn't do anything for me, but no side effects either. I would either just wait or take Finasteride. I wouldn't do a biopsi unless your psa keeps going up. I hope this helps.

    Mark

    Report / Delete Reply
  • Posted

    The F drug, like tamulosin, is likely to reduce your libido and ejaculation - but maybe you have reached an age where that is not so important?
    Report / Delete Reply
  • Posted

    I took it for about a year.  My urologist hoped that it would shrink my bladder, enabling me to void naturally again.  I was retaining urine in my bladder, and I have been self catheterizing for a year now to empty my bladder.  The finasteride did not improve things, so my urologist had me discontinue it last month.  I did not have any side effects from taking the drug.
    Report / Delete Reply
  • Posted

    I took it for 7 months. PSA did decline from about 3 to 2. No side effects. Did help just a little so discontinued. Planning to take it again if things get worse. Hank
    Report / Delete Reply
  • Posted

    I strongly advise against Proscar/Avodart in your case. Yes - these drugs help in the short term but over several years they stop helping and destroy your libido and energy. Also after 5 years you cannot stop them because if you do your prostate will rebound and grow like crazy.

    Also it is important to NOT have blind biopsies looking for trouble. If your MRI and DRE are ok then you most likely are ok too. There are many reasons why a PSA is elevated. What is more relevant is your PSA density which should be under 0.15. Use your prostate size to compute this.

    Finally, ask your urologist to do the SelectDX test on you. You can look it up. It analyses your pee after a DRE to look for DNA relevant to prostate cancer. It is very definitive and easy and cheap. It is used to screen men like you with a rising PSA to decide if a targeted biopsy is necessary. But without a target from your MRI you should be ok.

     

    Report / Delete Reply
    • Posted

      I've been having high numbers on my blood tests for PSA numbers.  I've been having blood tests because of other health issues.  Not a lot; the last one was to test my psa.  This sounds like something I may have to do.  What is a DRE?

      Report / Delete Reply
    • Posted

      You have to pee right after the DRE and that pee is sent for analysis to see if any DNA relevant to prostate cancer shows up. The doctor will do a rather vigorous massage of the prostate for a few seconds while he is also feeling for any lumps on the outside of the prostate. If any cancer cells are present on the prostate surface then a few of these will get flushed out in the urine right after the DRE. That sample of pee is then sent to the lab for DNA analysis (Select MDx).
      Report / Delete Reply
    • Posted

      Thankks for that.  I'll check it out and maybe ask my GP.  He seems to think that I had to either take a round of antibiotics, which I did, or do a biopsy... no other choice.  Great to hear there are other choices. The jury still seems to be out on how good of an indicator of PC the PSA score is anyway.  My doctor told me that when one has a score of 10 they start to get worried about it spreading to other organs.  Mine had gone from 5 to 9.  After the A/B it went down to 7.  I don't think it was the A/Bs though becausse I didn't have a noticeable infection.  Seems to me that my spike in PSA is because I have been regularly cathing for a little over a year and maybe I'm poking the prostate and irritating it.  

      Report / Delete Reply
    • Posted

      Yes - I CIC too and it raises my PSA quite a bit. Any irritation to the prostate will cause the PSA to rise. What is really relevant to those of us with BPH is the PSA density - not just the PSA since the enlarged prostate means we have more PSA activity just due to the prostate size and not due to cancer as might be the case for guys with normal size prostates. In my case my prostate is 240gm and my PSA is 24 which sounds bad but the PSA density is well below the value of 0.15 used for BPH patients to screen for cancer. Also, the trend over several years is important. Again in my case my PSA value wobbles between 12 and 33 over the past 2 years without any trend. The doctors look for a steadily increasing trend in the PSA over a few years as a sign of cancer.  The PSA test by itself is not a good indicator of cancer when you have BPH.
      Report / Delete Reply
    • Posted

      Yes - goodbye to blind biopsies! I've had 3 over the past 15 years because of a rising PSA and they all were negative but they caused me terrible pain and bleeding and infections. My uro a few years ago told me when it was negative that "there likely is cancer in there but he just missed it" !! I fired him after that.

      A few years ago I had a 3TMRI which showed a small lesion near the outer capsule. My uro at that time ( a different one I also fired) said he would a saturation biopsy of 36 cores!! I said no way and went to Dr.K in Houston who did a targeted biopsy of the tiny lesion using an MRI. Turned out it was just inflammation thankfully.

      Now I have a great uro in Detroit who is very pro CIC and against blind biopsies. He just did the SelectMDx test on me.

      There is another genetic test just approved for insurance called MicroGenDX. It examines the prostatic fluid that comes out during a DRE for any bacteria and if there is any then it identifies the bacteria and designs an appropriate antibiotic to be injected into the prostate. This could help reduce inflammation and the size of the prostate gland. I just had that done too. I would give you the link but this forum wouldn't allow it so please google it if interested.

      Report / Delete Reply
    • Posted

      I think it's quite possible CIC raises the PSA score - also sexual activity - 6 months ago I had PSA of 9.9 - the Urologist told me it might be due to CIC. I stopped CIC for over a month, refrained from sex for a week, had the test again and it went down to 2.4

      I wonder if they know - let's say PSA goes up due to CIC - does that increase the chance of PC on it's own?

      Report / Delete Reply
    • Posted

      Howard I'm curious what your new Uro says about CIC and PSA levels - my experience and someone else mentioned CIC apparently causes PSA levels to go higher. If it's true that PSA goes up as a result of CIC, presumably because it irritates the prostate, is that on its own something to worry about? My levels were 9.9 I'm 63, after I stopped CIC for over a month, and refrained from sex for a week it went down to 2.4. Other factors could be diet, I was getting a bit more sunshine and exercise so I'm not 100% sure it was just stopping CIC.

      Regarding leaving links I was told by moderator that they allow links. If the link is advertising a product they probably will not allow so the genetic test would probably get flagged as advertising.

      Report / Delete Reply
    • Posted

      Hi Mike,

      I've had my current uro for 2 years now and I really like him. He is the one who got me going on CIC and ordered my catheters. But his specialty is robotic simple prostatectomy for large prostates ( prostate cancer) and he always reminds me that if I ever get tired of CIC he has a table ready for me! He also does most of the other BPH procedures but at 240 gm I don't qualify.

      Your question is very relevant for me. I stopped doing PSA tests a few years ago as they are very misleading for men with BPH and often lead to unnecessary biopsies. But at my last visit 2 weeks ago we thought it would be interesting to get a value for me and compute the PSA density. The value came back at 35 which seems very high but the PSA density was 0.15 which is  ok though a bit high. When I told him I had done CIC 3 hours prior he dismissed the PSA test results as the catheter causes the PSA proteins that reside on the outer surface of the prostate gland to enter the blood stream. It is just a mechanical thing and nothing to worry about.

      Another good blood test though is Free PSA which is unaffected by prostate irritations like CIC and sex. That value should be above 15%. Mine in the same test was 35%.

      Still my uro did a SelectMDx test on me and I will know the results when he gets back from vacation in Europe!

      Report / Delete Reply
    • Posted

      Thanks Howard,

      Interesting info - why can't you do things like Turp or Green Light? My Uro did advise me to take Finasteride to reduce size to make any surgery needed and he said it works well on men with large prostates - it might have been working but nothing dramatic, and after about 3 months I was feeling a bit listless in general. I then read about sexual side effects which can be permanent, so I stopped.

      Report / Delete Reply
    • Posted

      Hi Mike,

      My prostate is much too big for those procedures (240gm). So I do CIC and have integrated it into my lifestyle ok.

      You are VERY smart to stop finasteride. I have permanent sexual side effects from it after 10 years and cannot get off of it as my prostate would explode in size. The benefits are gone after 5 years but the adverse side effects last a lifetime!

      Report / Delete Reply
    • Posted

      Thanks Howard I really appreciate that information.  My GP just seems to have a pretty limited knowledge of prostate issues.  This gives me something to research because I would like to avoid a biopsy which is what he threatened me with if I didn't do the doxycylin.  I know it seems odd to some here that A/Bs be used to lower PSA level but that was dr orders.

       

      Report / Delete Reply
    • Posted

      You are welcomed. Actually using antibiotcs for BPH is common since many believe that BPH started with prostatitis and if the bacteria in the prostate can be destroyed then the BPH (inflammation) will go away. There is so support for that idea.

      But the problem is identifying the bacteria which is very hard to do because they live very deep in the prostate unless you are experiencing acute prostatitis. By the time BPH shows up he prostatitis is in the chronic stage (if this idea is correct) .

      That is where the genetic test comes I t I mentioned above where they identify the exact bacteria from the DRE fluid and then design a proper antibiotic to destroy by injection into the gland. Otherwise the a/b is just a guess.

      Report / Delete Reply
    • Posted

      Is that right?  I didn't realize that.  Wonder why he prescribed that.  I'm not allergic to penicillin.  He has given me Sulphameth or something like that and then Cipro for 2 weeks before when I had prostatitis.  As Howard described earlier (and I was glad to get an affirmation of that) some doctors believe that BPH is caused by an inflamed prostate from bacteria rather than a permanently overgrown one.  I know my doctor had told me at one point that this was his goal in having me take antibiotics for urine retention.  

      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up