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Testosterone Replacement, Low T, HCG, & Beyond
Prostate Related Issues
Suffering with BPH
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<blockquote data-quote="Blackhawk" data-source="post: 143495" data-attributes="member: 16042"><p>There is a LOT missing in your self reported history, and at first glance it seems you may have a more old school uro.</p><p></p><p>I too am going through a prostate PSA rodeo. Most recently thankfully found a more progressive urologist who agreed that even with PSA at 9.3, my PSA changes over the last couple years are not at all typical for cancer. So I asked and he ordered SelectMDX test which came back entirely negative for cancer. i.e., my research and choice of doctor helped me avoid biopsy.</p><p></p><p>He was also agreeable if things came to a need for biopsy, that MRI prior to biopsy would be better as he could do a fusion rather than TRUS biopsy.</p><p></p><p>The problems with SelectMDX and in some cases MRI prior to biopsy is they are not covered by many insurance policies which supports the mainstream use of biopsy as first follow up for high PSA. (Biopsies also make the Drs a heap of money. Urologists make more money based on doing more procedures.)</p><p></p><p>And regarding TRT, there is no indication that it caused my PSA to go haywire. I have tracked it's progression related to T dosage an there is no correlation. My uro knows this history and made absolutely no mention of discontinuing TRT.</p><p></p><p>If you have a urologist who wants to stick needles up your taint first thing, and take you off TRT without first having proper diagnosis of cancer, it may be worth finding another uro.</p><p></p><p>Another aspect which might be pertinent to you, Dr Saya mentioned this and I have found other references, is that the prostate androgen receptors are saturated with total T around 250, so higher blood levels essentially make no difference. The time when androgen deprivation becomes pertinent is when they want to put you on lupron or casodex etc and drive your T to zero because you have had prostate cancer diagnosed. Just discontinuing TRT unless it drops your total T well below 250 is not effective. If your uro does not know these things, well...</p><p></p><p></p><p>I also have LUTS, nothing new, have had for around 20 years, but is has gotten worse in the last couple years. Dr Saya advised against, but 2 other doctors recommended to try saw palmetto. I tried for a few weeks, didn't do a thing. So next step may be Alpha blocker.</p><p></p><p>You certainly have it worse than I do, but what is the plan for you? Have you been offerred anything like Rezum, Holep, stent, laser, turp etc? There are many things available for relieving BPH.</p><p></p><p></p><p>And most importantly, why do you think radical prostatectomy is a solution? Have you been diagnosed with high grade aggressive cancer? If not, RP is a ridiculous choice. Is this all your uro has to offer?</p><p></p><p>Even with aggressive cancer, RP does not statistically improve long term outcomes. Urology statistics are shorter term, but too many cancers relapse because of undetected metastisies. Look up Bob Lebowitz compassionate oncology website and videos. He covers the actually dismal statistics for surgery and radiation therapy related to high grade cancers. You have to explore all options before letting them cut.</p><p></p><p>It is frustrating that with prostate there are not better more consistent outcomes for anything. There are a bewildering number of choices depending on specific diagnosis and few clear choices though many uros want you accept only what they have to tell you. My own outlook if push comes to shove is to continue to research things to death and get at least three opinions before deciding on anything.</p><p></p><p></p><p>LOL, BTW, just prior to my last blood draw and PSA of 9.3 I had been on a overseas motorbike trip! I wonder if it provoked that high PSA number.</p></blockquote><p></p>
[QUOTE="Blackhawk, post: 143495, member: 16042"] There is a LOT missing in your self reported history, and at first glance it seems you may have a more old school uro. I too am going through a prostate PSA rodeo. Most recently thankfully found a more progressive urologist who agreed that even with PSA at 9.3, my PSA changes over the last couple years are not at all typical for cancer. So I asked and he ordered SelectMDX test which came back entirely negative for cancer. i.e., my research and choice of doctor helped me avoid biopsy. He was also agreeable if things came to a need for biopsy, that MRI prior to biopsy would be better as he could do a fusion rather than TRUS biopsy. The problems with SelectMDX and in some cases MRI prior to biopsy is they are not covered by many insurance policies which supports the mainstream use of biopsy as first follow up for high PSA. (Biopsies also make the Drs a heap of money. Urologists make more money based on doing more procedures.) And regarding TRT, there is no indication that it caused my PSA to go haywire. I have tracked it's progression related to T dosage an there is no correlation. My uro knows this history and made absolutely no mention of discontinuing TRT. If you have a urologist who wants to stick needles up your taint first thing, and take you off TRT without first having proper diagnosis of cancer, it may be worth finding another uro. Another aspect which might be pertinent to you, Dr Saya mentioned this and I have found other references, is that the prostate androgen receptors are saturated with total T around 250, so higher blood levels essentially make no difference. The time when androgen deprivation becomes pertinent is when they want to put you on lupron or casodex etc and drive your T to zero because you have had prostate cancer diagnosed. Just discontinuing TRT unless it drops your total T well below 250 is not effective. If your uro does not know these things, well... I also have LUTS, nothing new, have had for around 20 years, but is has gotten worse in the last couple years. Dr Saya advised against, but 2 other doctors recommended to try saw palmetto. I tried for a few weeks, didn't do a thing. So next step may be Alpha blocker. You certainly have it worse than I do, but what is the plan for you? Have you been offerred anything like Rezum, Holep, stent, laser, turp etc? There are many things available for relieving BPH. And most importantly, why do you think radical prostatectomy is a solution? Have you been diagnosed with high grade aggressive cancer? If not, RP is a ridiculous choice. Is this all your uro has to offer? Even with aggressive cancer, RP does not statistically improve long term outcomes. Urology statistics are shorter term, but too many cancers relapse because of undetected metastisies. Look up Bob Lebowitz compassionate oncology website and videos. He covers the actually dismal statistics for surgery and radiation therapy related to high grade cancers. You have to explore all options before letting them cut. It is frustrating that with prostate there are not better more consistent outcomes for anything. There are a bewildering number of choices depending on specific diagnosis and few clear choices though many uros want you accept only what they have to tell you. My own outlook if push comes to shove is to continue to research things to death and get at least three opinions before deciding on anything. LOL, BTW, just prior to my last blood draw and PSA of 9.3 I had been on a overseas motorbike trip! I wonder if it provoked that high PSA number. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Prostate Related Issues
Suffering with BPH
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