Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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Dear Martin,
My PSA values have been between 8 and sometimes above 10 for the past few years. I have to take pills, Cazosin, to urinate and have to go to the toilet 20 times a day. Now I get advice from the doctor to go to BKK, RAMA hospital, for examination.
I know there's Firide, for prostate reduction, but taking that all my life won't help either. I also get a lot of dizzy spells on so many meds because I had a mild tia early this year. Firide and Cazosin both lower blood pressure.
Now my last question to you is what is the best thing to do, or take the risk and have my prostate removed? I had an examination, biopsy, done and it was not cancer.
I know there is a risk in everything, but at the moment this doesn't make me happy either.
Hoping for a positive answer.
Groet
A.
*****
Best A,
Looks like they've got you pretty good already. Instead of the biopsy, they should have done an MRI to prevent any complications. www.gezondheidsnet.nl/prostaat complaints
The prostate has been arguing for years now among specialists. In the past, much too aggressive action was taken, with the result that many millions of men were operated on unnecessarily. Many of them are permanently disabled as a result. The industry and many specialists have become rich with it.
In your case, however, these are serious complaints, which are probably mainly related to the size of the prostate.
Casozin (Doxasozin) relaxes the smooth musculature of the prostate which is said to make urination easier. I myself am not so convinced of the effect. Casozin lowers blood pressure.
Firide (Finasteride) does indeed measurably shrink the prostate. In addition, it promotes hair growth. It is not antihypertensive. A newer drug is Dutasteride. It is no better, but is better tolerated by some.
You can stop these drugs after a few years, when the problems have disappeared. If they come back, you can start again. When you stop, a lot of hair will fall out.
Urinating 25 times a day is a lot. I assume that a bladder infection has been checked, something that is often forgotten.
If you decide to have surgery, have a "green" laser treatment done. This dilates the urethra and does not have to remove the entire prostate.
The latest treatment comes from Israel, but it targets early-stage cancer. It goes with light.
That treatment is very successful and from the experimental stage: cancer-actueel.nl/prostaatkanker
My advice: Have the urine checked for an infection and start with Firide. For now, keep taking Casozin. If the complaints become less with the Firide, you can stop the Casozin on the basis of the blood pressure.
If all that does not help, then operate with the Laser. The abdomen does not need to be opened.
Yours faithfully,
Martin Vasbinder