some prostate concerns

[zahrani]

HELLO

Iam a 49 years old male
1-When I was 40 , I went to the doctor as I was having small drop of urine in the end  of urination, doctor told me not to worry and no examination was done.
2-five years ago ........ I had the  problem getting more while passing urine (when i pea few drops of urine  come out in the end ) I went to the doctor and he did a PSA test it was (0.78), and he did a Uroflowmetry and it was normal and he told me not to  worry about it and no medication is required.

3-three years later............, i started having more  dribble of urine  , I went to the doctor and again he did PSA test it was (1.21), and no treatment was suggested.
4-two years later ..........my symptoms got more worse and i went to the doctor , he did a DRE and told me the size of the prostate is bigger than normal , he did  a PSA test it was (1.35), and, then a transabdominal  ultra sound for the pelvic area was done  and  the finding was
*(URINARY BLADDER: Shows no stones or solid mass, with normal wall thickness )
(*(prostatic gland (prostatic gland is moderately enlarged in size, It measured (5.5 cm x5.01 cm x 3.9 cm  , it shows slightly heterogeneous parenchymal texture with large foci of calcification with smooth lobulated outline, Its calculated weight is ( 57 gm)))
CONCLUSION:
MODERATE PROSTATIC ENLARGEMENT
His diagnosis was  BPH (Benign prostatic hyperplasia ),  and he prescribed  Proscar and Omnic
My quesitions are:
1-Is  5-alpha reductase inhibitors (5-ARIs) safe?
  2- should  I be worried about  the elevation rate of my PSA ?

Thanking everybody in advance

[Circa49]

If your last PSA test was 1.35 and you only began taking Proscar AFTER that test,  then you do NOTneed to get a biopsy now.

The Proscar can reduce your PSA by 50%,  so future PSA results will have to account for that reduction.  Meaning  you may have to double your next score for a true value.

You need to make it clear what your status was when you took the last PSA test  1.35.   Had you already been on Proscar for some time?

Others have said "The increase is the key even if it is small."...
Right now you don't need to worry about that.  You have a enlarged prostate and there may be other reasons for the rise from one test to the next.   PSA scores can jump around wildly in some men for many many reasons.
You do NOT want to be running in for a biopsy every time there is the slightest indication.

If you are still worried,  see another urologist before asking for a biopsy.
(I assume your current doctor is a urologist....hard to tell from your post)
Anyway,  see another one for a second opinion if you want to.

Do not start asking for a biopsy now.

[Life360_Dave]

Hi also and i would agree with claytex and have a biopsy done now. Most doctor like to wait till the psa is around 3 but i think better to catch things early.
Have it done in a hospital and be put to sleep so the doc can do a good exam as in doctors office it can be painful and would distract the doc from taking his time.

[claytex]

Dear Zahrani:  I had a history of prostate problems beginning in my late forties.  they say my prostate was enlarged plus I had prostitis lots which I think is an infection in the prostate.  Finally I was having trouble urinating when I was in my late 50s and they did the roto rooter surgery on me.  When I was my late 50s, my psa began increasing slightly from 1.5  to 2.00 then to 3.00 (approximately...I don't remember the exact numbers). Anyway when I was 63 they did a biopsy and I had prostate cancer.  I had Proton Radiation treatments at Loma Linda University Medical Center in  Loma Linda,  California.  I am now almost 73 and doing fine... psa is .01  While taking the treatments in California, I meet lots of men who had prostate cancer and the common thing with almost all of them was they had slight regular increases in their PSA.  If I were you and it kept creeping up, I would have a biopsy done. The increase is the key even if it is small.  I met guys whose psa had increased form the 1 area to 2 and they had prostate cancer... the increase is the key.  Also if you ever have prostate cancer and I sure hope you don't, I would really recommend Proton Radiation if it is available to you./... It has a 90% cure rate and little to no side effects from the treatments... Its like I am cured and was never sick... I hope this helps you. Claytex