Question to GP Maarten: Enlarged prostate and Tia
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,
I am 60 years old, weight 68 kg, height 173, blood pressure sometimes 100 – 60!! and rarely higher so suffering from headaches and dizziness what can I do about this? I get checked every 6 months due to a tia in February 2017.
I have prostate enlargement and am taking medication for my prostate, Doxocasin and 1 aspirin a day because of the tia. My PSA is way too high, fluctuating between 7 and 10.
Now I had a biopsy done on 23-12-2016 and 14-03-2019 and both times they were unable to detect cancer. I get the PSA checked every 6 months.
My question is now, every how many months or years would you advise me to do this again or is it perhaps better to think about doing green laser irradiation and where, preferably not the more expensive hospitals because I have to pay for it myself and so they no longer hire me because of tia and prostate enlargement, in other words they do hire me but my ailments are excluded.
With the help of Doxocasin I can urinate normally.
What is your advice for both of these ailments?
Regards,
D.
******
Dear D,
With regard to the prostate, the following: If you want more certainty, have an MRI of the prostate. If it is clean, then you do not have to worry for the time being.
A PSA test is a very unreliable test anyway, which has already caused a lot of misery, such as unnecessary biopsies and operations, with many side effects. The test should have been declared obsolete long ago. The book “The Great Prostate Hoax” by Richard Ablin is devoted to this, among other things. Richard Ablin is the discoverer of PSA. Unfortunately, it has become a revenue model for urologists.
If you have problems urinating due to a prostate that is too large, a green laser treatment is an option.
It could be that the Doxosacin is causing your low blood pressure. Tamsulosin also has that effect, but to a lesser extent. Another possibility is 5 mg Tadalafil (Cialis) per day, but that is not an official indication for urinary problems. In any case, drink enough.
Green Laser irradiation is certainly an option in case of serious objections. In addition to the Bumrungrad Hospital, this can also be done in the Vejthani Hospital and the BNH Hospital, all in Bangkok. There are undoubtedly more, also elsewhere in the country. I don't know the prices, but negotiating is almost always possible. It shouldn't cost much more than $3.000. Perhaps the readers can help you further in that regard.
There is also the HOLEP (Holmium Laser Enucleation of the Prostate), also an excellent option. It is most likely used in the same hospitals. Then there is the new Tulsa Pro technique, which uses ultrasound. www.thailandmedical.news/news/new-mri-guided-ultrasound-protocol-eradicates-prostate-cancer
It is actually intended for prostate cancer without metastases. However, in Israel and now also elsewhere, they use photodynamic therapy (Tookad Soluble), a treatment of half an hour. Also from Israel the butterfly-shaped stent, which does not seem to cause any problems. Can also be removed again. www.xinhuanet.com/english/2018-12/27/c_137700886.htm
You see, we are working hard to solve your problem,
With kind regards,
Dr. Maarten
Readers can respond to the question about the price of a Green Laser irradiation for prostate problems. Please respond only to that.
To Maarten, I did an MRI in February in the Rama Tibodi hospital and then the biopsy in the BKK hospital in Udon Thani because there was doubt?? people who have ever done a green laser in Thailand and where this happened with preferably a price tag of approximately natural, peeling is also a solution.
Thanks to everyone in advance for thinking along and of course also to the editors for posting my request.
Dear Maarten and D, I had the green laser treatment a year and a half ago and I am extremely satisfied with the entire treatment and outcome and after care, no drips can hold the pee well,
the only thing that has changed is that the sperm enters the bladder, but that only matters if you still want children, the feeling remains the same, but no sex for 6 weeks after the operation.
I had this done in Malaga Spain because I also live there.
costs 5000 euros and 4 days in hospital a 500 euros pd,,, will undoubtedly be cheaper here in Thailand, but if I were you I would just do this, you can also find several responses via the internet.
there are also very well trained doctors here in Thailand.
Greetings and good luck with this, I hope this is of some use to you.
Harmen.
DR Santos malaga.executive physician urologist.
In addition,,,Doctor Alfonso Santos medico urologia , Malaga .. .