So--was it really BPH...or PC?

The thread on symptoms leading to dx. leads me to present a question I've always had (and I really doubt if I'll ever know the answer).

For many years (10-15) before my dx., I was having BPH problems. Once in awhile, I would get on flomax for a little while and things would clear up. For about 3 years prior to dx., I was taking flomax regularly, usually 1 a day and sometimes when things got bad, 2 a day. One time I got very close to going to the ER due to difficulty urinating.

Meanwhile, my PSA was very slowly rising. There was one significant rise but it went back down after a course of antibiotics.

Now, in retrospect, was it really BPH or PC that was causing my symptoms? How does one know? (Not that it really matters at this stage, but I have wondered about that!)

Mel

It depends on tumor size and location. If the tumor is large enough and constricts the urethea or pushes into the bladder it will cause BPH type symptoms. It also depends on how large your prostate is. You can have a large prostate, over 50cc, and still have PC, but symptoms your have will be due your prostate size not the PC.
JT

As John T says, the tumor size & location are the factors in these cases. In my case, I had SEVERE urination problems with a bad case of BPH. My PSA was slowly rising over a period of years as the urination became more & more difficult.

Then, after my PSA spiked up a couple points, a biopsy found that the BPH was also masking PC. In my case, the tumor was very small & near the apex, so I do not think it was causing my urination symptoms. Turns out that my prostate was 98.3 grams, which is 3-4 times normal size. The enlargement was squeezing the urethra and eventually would have twisted, deformed and probably began encroaching into the bladder neck -- if I understand my surgeon properly.

That is why I chose surgery over radiation. Like you, I was also using Flomax. Unfortunately, the Flomax lost its effectiveness after a few months, perhaps because the prostate was growing beyond the drug's ability to help me? I don't know the answer to that.

In any case, I'm glad that those 15 minute stands in front of the toilet are a thing of the past. LOL

Chuck

July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6. CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
mid posterior prostate. Right posterior apex margin involved by tumor over a 0.2 cm length,
doctor says this is insignificant.
Prostate 98 grams, tumor 2 grams.
Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
Post-op exams 2/13/12, 9/10/12 PSA <0.1
Only semi-erections so far, with continued improvement.