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Rising PSA, then BPH diagnosis

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Rising PSA, then BPH diagnosis

Old 10-17-18, 01:38 AM
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5kdad
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Rising PSA, then BPH diagnosis

A year and a half ago, I had a routine check up and found my PSA was high, at 4.79. However, a "percent free PSA" showed I was at only a 10% chance of developing prostate cancer for most men my age, 61, the chance is 1 in 3), so the doctor suggested a "wait and see" attitude. Since that time, it has continued to rise. Last month, it was 7.66. Urologist said it was time to get a prostate MRI done.
I had that done last week, and today got the results. Great news, no sign of anything suspicious.
But I do have an enlarged prostate, and the doctor thinks I have BPH, "benign prostatic hyperplasia". So I now have a prescription for flomax.
My urologist seems to have a bike-friendly mindset. Said he didn't think cycling contributed to prostate cancer, or more Tour de France riders would have that. But I do need a different saddle. I have a Brooks on both my road and mt bike. I showed him a photo of a Brooks with a cut out, supposedly to alleviate the prostate problem, but his opinion what that it didn't take the pressure off the affected area. I had bought one of the larger ISM brand saddles, to put on my indoor Schwinn Airdyne. So, just for fun, I put it on my mt bike, and was surprised to find it mostly comfortable (admittedly, I've only ridden it a few times, mostly around 6 miles). I showed the urologist a photo of the ISM saddle, and he approved of it.
If I don't have any other health surprises in the next year, I plan to take off on an extended bike "sabbatical" tour in the US. Just need to make sure I get a saddle that's not going to contribute to my BPH issue.
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Old 10-17-18, 07:23 AM
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I have BPH and had 3 biopsy's since 2007. I was 46 when I had first biopsy as PSA 3.2 then went to 3.8 6 months after and had another. Both were negative and 5 years ago had another after a 9 psa. That was negative and a recheck of PSA 6 months after was back to 4.5. Since then psa runs around 4.8 not rising but I had Greenlight PVP back in May. I could hardly urinate and was retaining a lot of urine. It help a lot and now I can go fine. I have to go in for follow up next month and will see. PSA of 7.66 is high but if your prostate is really large it can show higher levels. I would see about having the greenlight if you get any problems. I actually waited too long and the effects on my bladder no so good. Now I can ride for 3 hours and not have to stop and pee 3 times, before the laser it was getting really bad.

I am surprised at the MRI of prostate I did not know they could use that to detect cancer. Biopsy is pretty standard although not fool proof it can only show that the cores they took either have cancer or did not. They can miss the cancer.
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Old 10-17-18, 09:03 AM
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Originally Posted by deacon mark View Post
I have BPH and had 3 biopsy's since 2007. I was 46 when I had first biopsy as PSA 3.2 then went to 3.8 6 months after and had another. Both were negative and 5 years ago had another after a 9 psa. That was negative and a recheck of PSA 6 months after was back to 4.5. Since then psa runs around 4.8 not rising but I had Greenlight PVP back in May. I could hardly urinate and was retaining a lot of urine. It help a lot and now I can go fine. I have to go in for follow up next month and will see. PSA of 7.66 is high but if your prostate is really large it can show higher levels. I would see about having the greenlight if you get any problems. I actually waited too long and the effects on my bladder no so good. Now I can ride for 3 hours and not have to stop and pee 3 times, before the laser it was getting really bad.

I am surprised at the MRI of prostate I did not know they could use that to detect cancer. Biopsy is pretty standard although not fool proof it can only show that the cores they took either have cancer or did not. They can miss the cancer.
I think the prostate MRI is something fairly new. It was my understanding that they'd had the equipment to do that for sometime, but didn't have anyone with the "eyes" to properly read the MRI. So glad it was a step they could offer, before the biopsy step.
Really appreciate your reply and information. I'd not heard of the Greenlight PVP. Where did you have that done? My doctor is in Springfield, MO.
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Old 10-17-18, 09:28 AM
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I had BPH two years ago at age 65. Had a procedure called button turp, similar to green light.
Big difference now, don’t need to go nearly as much as before. PSA has been at 2.5 since then until last week it went up to 3.
He said we will just keep an eye on it maybe do a mri in 6 months.
i went from a hybrid to a road bike 2 months ago not sure if that had anything to do with it. May get a different saddle.
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Old 10-17-18, 11:36 AM
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Thread moved to 50+ Pills and Ills forum.
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Old 10-17-18, 12:18 PM
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I had the greenlight therapy done the 10th of September and it did the job for me. Your urologist is the one that should be able to do it.
I asked if the bike riding caused the problem and he said no. I did buy a Smp saddle and a week after the surgery I could ride again. I’m going to wait another week before I start riding again just to play it safe.
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Old 10-17-18, 01:48 PM
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Man, at 53, my PSA is low (IIRC, a 1 or 2 at most), but I have this uncomfortable feeling that I don't empty my bladder completely when I go. My PCP is a woman, and she has never done a DRE of my prostate -she has said that she can't perform the test adequately on most male patients because she is a very tiny Asian woman, about 5'1", with proportionately tiny hands, and her finger isn't long enough (hope that's not TMI, guys!). She refers all of her male patients with problems or concerns to a urologist. I haven't taken that leap yet, but I really should, since this issue isn't going away, it's been getting worse over the past few years. It's probably a sign of BPH. I guess I should just bite the bullet and get it over with.
"
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Old 10-17-18, 02:00 PM
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Originally Posted by DaveQ24 View Post
Man, at 53, my PSA is low (IIRC, a 1 or 2 at most), but I have this uncomfortable feeling that I don't empty my bladder completely when I go. My PCP is a woman, and she has never done a DRE of my prostate -she has said that she can't perform the test adequately on most male patients because she is a very tiny Asian woman, about 5'1", with proportionately tiny hands, and her finger isn't long enough (hope that's not TMI, guys!). She refers all of her male patients with problems or concerns to a urologist. I haven't taken that leap yet, but I really should, since this issue isn't going away, it's been getting worse over the past few years. It's probably a sign of BPH. I guess I should just bite the bullet and get it over with.
"
Go see a urologist even with a low PSA it does not mean much as the concern is how fast it is rising in relation to the baseline. A baseline PSA of 3 is higher depending on your age but going from 3 to 3.5 is not the same as going from 1 to 1.5. The jump is bigger on the lower numbers. The DRE can tell much if prostate has issue. Getting it early is the key. At some point in advanced age maybe over 75 to 80 they find that those prostate cancers are less aggressive and you probably will die of something else before the prostate cancer. Usually the younger the diagnosis the mover aggressive it tends to be. Get it checked.
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Old 10-17-18, 03:30 PM
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Which ISM saddle did you get?

I'm trying a demo of the Attack right now, but it feels shortish. Will try one of their longer saddles next. Have been on an SMP for years trying to avoid prostate issues.
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Old 10-18-18, 05:27 AM
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Originally Posted by 5kdad View Post
But I do have an enlarged prostate, and the doctor thinks I have BPH, "benign prostatic hyperplasia". So I now have a prescription for flomax.
.
I used Flomax briefly after brachytherapy for prostate cancer. It made me have dizzy spells, so beware!
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Old 10-18-18, 08:30 AM
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Originally Posted by nesdog View Post
Which ISM saddle did you get?

I'm trying a demo of the Attack right now, but it feels shortish. Will try one of their longer saddles next. Have been on an SMP for years trying to avoid prostate issues.

My LBS had a used ISM Adamo bike saddle that I could "buy and return" if I didn't like it. They are very prostate friendly. But I hated it! It was terribly uncomfortable. I also have a Schwinn Airdyne bike I ride indoors, so I bought an ISM "Cruiser" saddle for it. Found it more comfortable than the stock saddle. So decided to give it a try on my mt bike. Don' laugh, it seems to work. Admittedly, I've not done a long ride with it yet, longest was 11 miles, but it seems to be ok. I'm going to put the "Cruiser" saddle back on the Airdyne bike, and have ordered the ISM "Touring" saddle. I might add, I'm 5'6" and weigh 220, so that might have some effect on what saddle works best for me.
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Old 10-18-18, 08:33 AM
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Originally Posted by Artmo View Post
I used Flomax briefly after brachytherapy for prostate cancer. It made me have dizzy spells, so beware!
Yes, my doctor warned me about that. Said to be cautious when I get out of bed.
I seemed to be a bit more tired than usual yesterday afternoon. I check my blood pressure. It was 105/65, which is much lower than normal for me (I'm on high BP meds). Usually it's more around the "ideal" range of 120/80.
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Old 10-18-18, 08:34 AM
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Originally Posted by cb400bill View Post
Thread moved to 50+ Pills and Ills forum.
Thanks. I had not noticed this sub category.
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Old 10-18-18, 08:50 AM
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I saw a caution about dizziness with alpha blockers and wanted to add to it. It doesn't effect everyone but it can be an issue for some of us riders. I took Flomax for many years without noticing any side effects. But after taking up cycling 13 years ago I did. The first time, I got dizzy during a break in the middle of a hot ride and passed out. The second time I had a similar experience, again after a longish, hot ride. My doc took me off Flomax and the problem was largely alleviated but then returned in a much less disruptive fashion. Turns out I get periodic SVT (supraventricular tachycardia). It hits me a couple of times a year, virtually always on a ride. I can feel a fast heart beat and dizziness. Unlike the episodes while on Flomax, I can pull over to the side of the road and elevate my legs for a few minutes and it goes away. I haven't passed out since I stopped the Flomax. I don't know whether the Flomax exacerbated an existing problem with SVT or whether it may have actually led to the SVT. I would recommend being alert to any incidents of dizziness and seek other options (like Avodart) if the Flomax causes serious problems. Flomax worked better for me than Avodart so if I didn't have the passing out issue I would have continued with it.
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Old 10-24-18, 06:47 PM
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Originally Posted by Artmo View Post
I used Flomax briefly after brachytherapy for prostate cancer. It made me have dizzy spells, so beware!
Same here - 53 and my doctor this year prescribed Flomax. It drops blood pressure and I quit taking it after a month or so because every time I stood up I got dizzy and light headed. While on the meds it did help a little but I just need to look at other options.
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Old 10-26-18, 11:28 AM
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I'm a little late to this thread but here's my experience with BPH. About a year ago at 68 yrs (at the time, now 69) I had a spike in my PSA. The urologist wanted a biopsy and so went where no man has gone before. I had already been diagnosed with BPH but due to previous low PSA cancer wasn't a big concern. Anyway, the biopsy was negative for the big C. He then put me on Proscar (generic form). Except for slow flow (not stop and go) with the first wiz in the morning, I was/am fine. Subsequent flo during the rest of the day was a bit slower than when I was 20 but not bad and much better than the first one of the morning. After starting the generic Proscar I didn't notice any difference with the first one in the morning but the subsequent ones for the rest of the day, the flo certainly increased. The great thing about the Proscar, as far as side effects, is there were no side effects that I noticed.


I've got an appointment for the yearly checkup in Nov. Right now my generic proscar prescription ran out about a week ago and I didn't try to have it refilled. I didn't attempt to have it refilled as I'm doing a bit a "testing" to see if the improvement in flo remains or if slow flow comes back. I hate taking medications of any kind (unless absolutely necessary) and have always gone by the old doctor adage of "show me a medication with no side effects and I'll show you a medication that doesn't work". It's only been a week but so far there has been no change in flow but 4 weeks off proscar might be a better indicator. If the slower flow comes back, I'll simply start the generic proscar again.


Bottom line sentences to all that: I can't say if someone else would have side effects taking Proscar or not but I didn't have any. Maybe ask your urologist about Proscar.

Last edited by LesG; 10-26-18 at 11:31 AM.
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