Can you reduce the size of a prostate with dietary changes?
Not that I'm aware of. Prostate reduction of can be accomplished with, you know, different
interventions— laser treatments, TURPS, things like that, and then the medications that will
shrink the prostate, or different forms of hormone treatment that block testosterone—the mildest ones
are Proscar and Avodart—and then as you go up the list of stronger medicines like Casodex and
Lupron, all of those things will reduce the size of the prostate. There's a misconception that all
urinary problems seem to originate from, or it's believed, that they originate from
the size of the prostate, and that's only true in a minority of cases. A lot of urinary problems
are related to the fact that as we get older the bladder wall gets more irritable,
and prostatitis, other things that can cause urinary symptoms are unrelated to how big the
gland is. Sometimes, a large prostate does create urinary problems. Large prostates can
present a challenge for certain treatments like radiation therapy, so men that have big prostates
are probably better candidates for focal therapy because you can put a little bigger margin around
the tumor without destroying the whole gland, so there are even advantages to having big prostates,
but the capacity to shrink the prostate with medications is, you know, really confined to
things like Proscar and Avodart. I'm not aware of diet having any impact at all.
Why does tamsulosin cause nasal congestion, and is this a long-lasting side effect?
The way that tamsulosin works—it's an alpha blocker—it relaxes the muscles in the urethra,
allows a more open and free flow of urination from the bladder through the prostate and out the
penis. These same medicines can cause relaxation of the muscles in the walls of the arteries in
the nasal area causing greater blood flow which just basically activates the glands that are up
there that create mucus, and it's reversible when the Flomax is stopped. It's not a common problem;
well, it is one of the more common problems, but it doesn't occur that commonly with Flomax. It's
a issue that occurs with all the alpha blockers such as Urotrol and and Rapaflo, other products
of this genre, and it is sometimes irritating enough that people can't take the medication, but
most people don't have a problem like that and it is reversible when the medicine is stopped.
So, we have a patient who's 57 years old. His PSA 18 months ago was 178
and his Gleason score, according to the pathology. was 3+4,
and so he took Zytiga. The PSA went down to .01 and he wants to know,
Erleada has now been available in his country and so he wants to know if he could switch from Ztyiga
to Erleada in order to get rid of the side effects of prednisone that he's taking with his Zytiga.
He certainly can, and we generally believe that Erleada and Zytiga are more or less
interchangeable in terms of their anti-cancer efficacy. Erleada doesn't require prednisone,
and so that may be advantageous for some patients. The dosage of prednisone for
Zytiga patients is relatively small and it's usually well-tolerated. There has been some
suggestion that the dose can be safely reduced from 10 milligrams a day to 5 milligrams a day,
which would reduce any potential side effects to some degree. There are some studies showing
that you can change out the prednisone for a potassium sparing diuretic called Inspra,
otherwise known as a Eplerenone (known as a generic name for that) to keep the mineral
balances in appropriate control and allow you to get rid of the prednisone altogether. So,
there are other workarounds but it's perfectly reasonable also to consider using the Erleada
rather than the Zytiga. If people have been on prednisone, they have to be tapered off. You can
stop the Zytiga in a day but prednisone can create a dependency and if the adrenal glands stop making
cortisone when during the prednisone therapy, stopping the prednisone suddenly can cause a
deficiency of cortisone in the system which can manifest as very severe tiredness. So,
there is a whole pro forma for tapering prednisone when people finally get around to stopping it.
Hey everybody, it's me Alex and our mascot here Hunter. He's obviously licking my hands because
we have lots of treats for him today, but yeah, we just wanted to let you know to go ahead and
subscribe to our YouTube channel; we come up with new prostate cancer videos every week,
and go ahead and check him out on instagram; it's SirHunterTheDal. Also check out our website,
pcri.org, for more information about prostate cancer. We hope it helps.