Size of prostate and potential cancer risk

[Guest Posts]

I am a 71 year old male who experienced problems with urinating for a few years. I eventually went to the doctor about 6 years ago and he did a couple of checks and said that I had an enlarged prostate and sent me to the local hospital. The consultant there did a few further checks and found my PSA was 5 and stable (this has dropped ever since and has been around 2.5 and currently 2.39 thanks presumably to the prescribed medication). An ultrasound scan showed up "a really quite impressively large prostate" according to the consultant and he sent me for an MR scan which yielded a reading of 205 cc for the prostate and he said that the chances of my having a clinically significant prostate cancer which could cause future problems were very tiny. He also said that due to the size of the prostate, he would refuse to surgically reduce this and said that the only answer to this MAY be to have laser surgery elsewhere but would not recommend this. He discharged me and I have only seen the local GP since then with annual PSA checks and occasional changes to medication. The prostate continues to give me no problems apart from the obvious nightly toilet trips which wear you out and the need to be on guard for a toilet location when out and about.
I have the following main concerns please. (a) Should I be worried about the potential cancer risk; (b) should I be having any scans etc to check the current size of the prostate and (c) is there anything at all that can be done to give me a good night's sleep as it is so long since I have woken in the morning feeling refreshed?
Thanks KWS

[mr jonathan noel]

Thank you. To answer your questions:

(a) Should I be worried about the potential cancer risk.

You should get yearly PSA checks and their value should be adjusted to medication (finasteride for example usually decreases the true value by 50%). If it is above the age reference range your GP should refer you to a Urologist.

(b) should I be having any scans etc to check the current size of the prostate

Only if your symptoms are worsening or you develop new symptoms that are bothersome. A patient without bothersome symptoms of benign prostate enlargement does not need regular scans.

(c) is there anything at all that can be done to give me a good night's sleep as it is so long since I have woken in the morning feeling refreshed?

A urologist will need to clinically assess you but in general we advise to lower fluid intake at night, particularly caffeinated beverages. A clinician may also prescribe medication or change existing medications.

[kevsuepoo]

Thanks for your reply. I was not aware at all that finasteride usually decreases the true value of the PSA esult by 50%, which in my case would push the PSA level up to the (worryingly) 5 mark almost. I currently take 3 tablets daily, namely finasteride, atorvastatin and alfuzosin and wonder if I should get back to the GP regarding this. What would you suggest please?
Thanks KWS