What are the symptoms of an enlarged prostate and how is it treated?

A well written and educative article!

It is described how consultations and screenings related to prostatic health problems sharply increase when there are news about some famous person having them, this article is a nice complement that may help some people deciding to finally pay attention to their problem and consult with a doctor.

It is also nice the detail at the end about unproved treatments, it is important to clarify for patients that some things are being pushed as effective without any actual evidence behind them.

Men with interrupted urine flow can 1/ sit down on the toilet to pee and 2 /when the stream starts, lean forward and grab your ankles.

Works for me.

I''ll be patenting step 2.

"The Guru Move " is a working title.

There's not strong evidence for herbal remedies such as saw palmetto.

True.

But there persists some antidotal testimonial evidence by some patients that Saw Palmetto (SP) does works. For them. But they are often the first ones to admit that it didn't work for their friends and family.

Aside from a placebo effect, there might be a reason that it works for a few.

A study done back in 2021, that was not peer reviewed (link below) reported that "saw palmetto and beta-sitosterol have also been suggested to reduce NFκB activity, indicating that NFκB activation may be involved in driving and/or supporting hyperplastic growth." (FNs omitted). But note that their work was on BPH incidence in the presence of auto-immune (AI) disease. And the meaning behind what the authors theorize follows AI's inflammatory effects on tissue growth and resistance.

Takeaway? SP might cause some inhibitition in some BPH in some AI cases. Most that can be said at this point. Particularly since the authors also said that BPH patients uniformly have one or more of a variety of micro-anatomical features that can contribute in combination to cause this condition. Much more work needs to be done, but if the authors are eventually deemed to be correct, then SP might be someday included in the list of things that could work for some, but not for others.

https://www.biorxiv.org/content/10.1101/2021.03.11.434972v1.full

Anecdotal only -

I have BPH. First diagnosed 12 years ago when I was checked after an elevated PSA reading.

Had MRI and biopsy. Size was nearly 3 times larger than "normal" and a little irregular in shape.

Took prescribed medicine for a week to stop inflammation, but had some side effects which was troubling as a fulltime worker.

Researched and found that Saw Palmetto/Beta-sitosterol supplements (incl other ingredients) were very commonly taken in Europe with positive reviews.

Bought first product and peeing returned to young man "normal" in a very short time.

Have twice yearly checkups. 6 months ago had an MRI. Hyperplasia still exists but my prostate has shrunk over the years by half.

My urologist derided my decision originally, but he realized after a few years that something was helping.

So I will keep taking the supplements. One point is to check/verify carefully the source and ingredients of the product. As we know - all things are not equal, incl doctors and prescription medicines.

For those with similar problems it's worthwhile to trial.

If it works - good; if not then back to doctors advice.

browny1

Thanks for writing.

Your doctor likely already went into this earlier, but:

Important: Please keep in mind that compounds in saw palmetto have been shown to have some blood-thinning capability, particularly if / when combined with an anticoagulant drug, such as (but not limited to) warfarin and /or NSAIDs, or when consuming any food, herb, or OTC supplement that has a potential for increasing a risk of bleeding. Your pharmacist / chemist can help you with this.

Please take steps to see that your intake of saw palmetto is charted in all of your medical, pharmacy and dental records. Dosage may matter, so let them know how much and how often you are taking this.

Please seek the advice of your doctor if you think you may undergo any type of surgical procedure, so as to decrease the risk of postoperative bleeding. Risks can be mitigated, but doctors need to know very early on.

Best of luck with your health. Take good care of yourself.

At the beginning of 2020, my prostate was removed by laparoscopic surgery because of more than 90% cancer and the size of a baseball. Since then I have been free of cancer but I need to take several drugs daily and three monthly tests. I also had the lymph nodes removed.

Life-changing surgery.

There are several methods for reducing an enlarged prostate. Not should which one King Charles had at the London Clinic. Worked there back in the 1980s.

The after-effects of an operation for reducing an enlarged prostate can also become life-changing. Drugs might be able to reduce it and if not then an operation.

There are many new treatments for treating the prostate including when there is cancer.

A ‘Life-Changing’ Treatment for Enlarged Prostate

https://www.cedars-sinai.org/newsroom/a-life-changing-treatment-for-enlarged-prostate/

Transurethral resection of the prostate (TURP).

"This is the most common surgery to treat BPH. Your doctor removes portions of the prostate that are affecting your urine flow. There is no cutting and no external scars are seen since a scope is inserted through the urethra to remove the excess tissue."

I think he needs gout treatment for his sausage fingers.

In Britain and much of the world PAE, Prostate Artery Embolisation is a common treatment. In Japan in 2016 there were only four or five hospitals in Japan that performed this operation.

An interventional radiologist inserts a catheter in the artery that deeds blood to the prostate. Plastic balls are inserted in the artery to partially block the flow of blood to the prostate. This causes the prostate to shrink. The operation is less likely to have side effects than more invasive techniques. One side effect of more invasive techniques is retrograde ejaculation.

If you are seeing a urologist about your prostate, ask about PAE, and if your urologist doesn't know about it, find another urologist. You could try the Keio University Hospital or Hiratsuka City Hospital. They work together on this or did in 2016.

gaijintravellerToday  11:25 am JST

In Britain and much of the world PAE, Prostate Artery Embolisation is a common treatment. In Japan in 2016 there were only four or five hospitals in Japan that performed this operation.

An interventional radiologist inserts a catheter in the artery that deeds blood to the prostate. Plastic balls are inserted in the artery to partially block the flow of blood to the prostate. This causes the prostate to shrink. The operation is less likely to have side effects than more invasive techniques. One side effect of more invasive techniques is retrograde ejaculation.

If you are seeing a urologist about your prostate, ask about PAE, and if your urologist doesn't know about it, find another urologist. You could try the Keio University Hospital or Hiratsuka City Hospital. They work together on this or did in 2016.

Excellent info. I think the best thing men can do is dietary, LESS animal proteins, processed foods, sugars, alcohol and MORE plant-based proteins, veggies and fruits, Fiber also IMPORTANT, beans and whole grains.

If you're regular/good digestions and sleep well, then you're likely in a good place and on a healthy path.

it is important to clarify for patients that some things are being pushed as effective without any actual evidence behind them.

Indeed, that is a very good point. This is an extremely common thing...

Medical science does not know why the prostate enlarges.

"Factors linked to aging and changes in the cells of the testicles may have a role in the growth of the gland, as well as testosterone levels. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH."

How many men will have prostate problems?

"But because an enlarged prostate, or benign prostatic hyperplasia (BPH), is a common condition that affects men as they age, it's important to know the facts. About 50% of men between the ages of 51 and 60 have BPH, and that number jumps to 70% among men aged 60 to 69 and around 80% of men over 70 years of age."

One in eight men will be diagnosed with prostate cancer.

Since King Charles announced his problems more men in the UK have requested screening.

https://www.nationalgeographic.com/science/article/enlarged-prostate-cancer-aging-health

Surprised that the article did not mention use of medications first.

Medications are first prescribed to make the prostrate smaller.

If after use of medications, the prostrate is not small enough and men have trouble urinating, then the above solutions come in play.

I suspect many older men reading this have prostate problems. I also suspect many men have problems but don't even suspect they have them. Over a certain age it is good to have a check for both prostate cancer and an enlarged prostate and also a test for urine retention, which may be for other reasons. As we get older, our body changes. Many of these changes such as prostate, hearing, eyesight are so gradual that we do not notice them. If you are waking up at night to go for a pee, it could be because simply you drank too much beer, but it could be because of an underlying problem like diabetes or a prostate problem. Try to catch such problems early before they become more or cause other problems.

Indeed, that is a very good point. This is an extremely common thing...

Mostly by people using youtube videos as "primary sources", that is why it is so important to refer to proper institutions of medical science instead of rogue people that recommend things in absence of evidence (like the example in the article) or even worse, when there is contrary evidence.

I didn't know I had prostate cancer. I was peeing a little more but thought it was just my age. Had an annual health check which included a PSA test. 50. Fortunately, the cancer was only in the prostate but if I had left it any longer it could have spread. There are very symptoms of prostate cancer.

They will perform a rectal exam to determine the size and shape of the prostate.

Damn. The last king lived to over 90. He seemed very slim and trim with a daily exercise routine.

Reading an Aust. Doctors advice, he said the "rectal exam " not really done anymore.

MRI covers this.

MRI and a biopsy is the procedure.

If a person has prostrate cancer there are treatments available other than surgery.

In my case many years ago when the Urologist took about dozen samples from my prostrate, two samples showed signs of cancer.

The Urologist does the surgery by remote control sitting at a desk and looking at a monitor and guiding the robot that does the surgery. He explained that to me.

Other two options were Radiation treatment and Brachytherapy.

I was not too keen on the surgery and consulted with the doctors that do Radiation treatments, many times. I was not too keen on that.

For Brachytherapy, I did a lot of online discovery for 3 months and also reading the reviews of people who had done it.

For the treatment, a person with a very enlarged prostrate would not qualify for this as the doctors look at the prostrate and place a graph as a guide.

They have to see the whole prostrate in their special micrograph as they place about 150 rice size iodine radiation seeds into the prostrate.

The seeds work about 18 months and kill any cancer in the gland. It is a one time treatment. The seeds stay in the gland.

I opted for that.

It's been many years and my PSA test each year has been below 1. Up to 4 is acceptable.

Jind

I recommend everyone with prostate cancer to look at all the options. You were able to choose the right one for you. In my case, the prostate was more than 90% cancer and very enlarged and could spread the cancer to other parts of my body. So after much discussion with my doctors, it was removed. That solved the cancer problem but created new problems which I need to manage.

There are also new treatments happening.

For those who have or had prostate cancer one of the most critical points is what was the Gleason score.

A tumour with a Gleason score of up to 6 with a 3 + 3 rating is now considered by many learned urologists/surgeons as not even cancer.

However there are many doctors who will still recommend surgical removal - allowing for the possibility of a number of post operative problems - even with this low score.

100,000s of Gleason 6 men in the states( I think) were followed over a long period and there were no cases of a Gleason 6 tumour metastasizing. In cases where cancerous cells developed, they were found to be unrelated to the original tumour.

Be very well informed and up to date about all aspects of BPH and cancer when discussing with your urologist. Some are still back in the 20th C.

The Gleason score is not used by urologists in Japan, at least from my experience.

From my personal experience, cutting out coffee had an immediate and drastic effect on improving urinary function.

wallace -

The Gleason score was the first result given to me by my doc after my biopsy.

At 2 other hospitals in my city that I know of it is the standard.

A friend in a neighbouring city also had a Gleason score of 6. He was 75 years old at the time and his doctor said he needed a soon as possible prostatectomy.

He has said to me more than once that he would be dead now if not for his great doctor.

I've never said anything to him about his diagnosis and operation - no meaning. He's now 82.

Point is he had a risky for his age operation that was not required.

Probably my favorite comment ever.

Men with interrupted urine flow can 1/ sit down on the toilet to pee and 2 /when the stream starts, lean forward and grab your ankles.

Works for me.

I''ll be patenting step 2.

"The Guru Move " is a working title.

browny1

wallace -

The Gleason score was the first result given to me by my doc after my biopsy.

> At 2 other hospitals in my city that I know of it is the standard.

I assume you mean in Japan. I had a PSA test which was 50+mg/l. Then I had a biopsy. The urologist said he found cancer in 12 out of 13 locations. 90%+ my prostate had advanced cancer. An extensive full-body MRI showed the cancer had not spread. The was no discussion about the Gleason score.

I had stage 3 cancer.

Stage III: PSA levels are high, the tumor is growing, or the cancer is high grade. These all indicate a locally advanced cancer that is likely to grow and spread.

For those interested in combating the risks of cancer if and when becoming a similar age to HRH then I leave links to two studies

https://pubmed.ncbi.nlm.nih.gov/27033442/

https://hwww.ncbi.nlm.nih.gov/pmc/articles/PMC4039155/