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Assuming the metastatic workup is negative (bone scan, CT scan, MRI, etc.) you need to ask your urologist what the likelihood of "cure" or 10-year PSA free recurrence is in somebody with your particular Gleason score, PSA, etc.
Next, you need to look at the risks and side effects of each treatment -- whether its radiation, proton beam, etc.
Then spend some time weights the potential benefit of any treatment versus the risks and decide what is right for you.
best of luck,
BTView Thread


If its still elevated and you are not wishing to undergo a repeat (extended) prostate biopsy, you can consider use of a 5-alpha reductase inhibitor (proscar or avodart) with serial PSA checks or possibly an MRI. (assuming the PSA remains elevated)View Thread

One option is to consider using a 5 alpha-reductase inhibitor (proscar or avodart) to see how much the PSA decreases. Ideally should be at least 50% although in your case if your PSA rise is from a benign cause I would bet it would come down even more.
I would definitely re-check the PSA once or twice over the next few month and if it still elevated you may also want to consider an MRI at an institution that does a high volume of prostate MRIs.View Thread


best of luck
BTView Thread

If calories burned is greater than calories consumed you lose weight.
Try Fitness Pal -- its an app for Ipad or PC. you track your daily food and exercise. It gives you a calorie score. Stay under it and you will lose weight.
I've never seen it not work in any of my patients.View Thread

One app that has helped a lot of my patients is "Fitness Pal." Basically you record everything you eat and every exercise you do and it gives you a calorie "score" for each day. Stay under and you lose weight. Pretty simple. I've never seen it not work if you use it.View Thread

There are some algorithms you can find online now where you enter your information and it tells you likelihood of a positive biopsy.
Bottom line is this:
1. If you have made up your mind that you would not treat prostate cancer even if you had it, then don't do a biopsy and stop checking your PSA
2. You are exactly right in saying that not all cancer needs to be treated at the time of diagnosis and in many cases not at all. The key is having the information -- which the biopsy gives you.
3. If you are strongly opposed to a biopsy, have BPH, and still are concerned about missing a significant cancer, ask your urologist about the possibility of starting a 5-ARI (Avodart of Proscar). It will treat the BPH and cut your PSA by 50% -- typically within 6-12 months. If your PSA is rising on one of these medications, that's a red flag.
best of luck
Dr. TareenView Thread

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