Anxious to get a feed back from Johns Hopkins (haven't heard yet)regarding their pros and cons on the medication Flomax.

I also would like your thoughts on Flomax. I have been on it for a week, but understand it may take longer to become fully effective.

I have been taking Doxazosin Mesylate (Cardura) for about 10 years, since I was 58. I started out at 2 mg, and in my mid-sixties I was prescribed 4 mg because 2 mg was no longer adequate. Several tests (including transurethral examination and a needle biopsy--twice in 10 years) have found no evidence of Cancer. My PSA score has been somewhat elevated at times, but usually not enough to cause alarm. About 18 months ago my urologist prescribed Advodart to shrink the prostate. I had a bad case of prostatitis, but recovered in a couple of weeks. While I had the prostatitis, I got the approval of my PCP to increase the Cardura to 6 mg, 2 in the morning and 4 at bedtime. Then I went back on 4 mg. During all of this time, over the past 2 years, I had two or three mild cases of syncope, which seemed to occur when working in the yard on a hot day. I did not loose consciousness but felt faint. More recently, I had more serious episodes. I went to the ER after falling, when I passed out for a split second. This took place after hiking in the woods for about 6 or 7 miles, during which time I got lost and had some moments of near panic. Numerous heart tests have found no heart problem. My urologist took me off the Cardura, but after a few days I got his approval to go back to 2 mg daily because I was having problems urinating that I had not had for many years.

I know that the Cardura is suspect as a cause of the syncope. If no other cause is found, am I risking more serious problems by continuing to take 2 mg? Would another medication be advised?

I am 73 years old and have had multiple psa tests since 1983 and had a biopsy in 1994 (negative). The PSA levels have ranged from over 2.0 to the recent 5.3 and 2 wks ago 8.3. The free PSA is 23. At the time of the last PSA test I previously ate at the now infamous Taco Bell and had a short bout of diaharea. Is it possible that the PSA and the free PSA spiked ? The urologist now wants to perform a Transrectal Ultrasound/Biopsy but I am insisting that I go through a week on an antibiotic and then have another PSA test. Am I full of "wishful thinking". I am not overjoyed at the prospect of having a needle thrust through my rectum wall and the into my prostate. I have no existing problem with my rectum and don't like the idea of having it punctured. Is there any other way to get a sample of tissue?

Initially I used Cardura for around 8 years. For quite some time it worked well, and except for the dizziness experienced when I bent over and then stood up, it was OK.

When it ceased to be effective about 3 years ago, I was put on Flomax, which I still use. Howver, the good effects of Flomax are starting to subside. As a result I went through the various screening tests leading up to a TURP procedure, and was ready to go with it until my primary care physician suggested surgery was not a good idea. I was happy he said to wait, as I read about TURP and decided I didn't want it's side effects.

I've also experienced prostatitis, especially after the needle biopsy, and treated it with Cipro. Currently I am about a 19 on the BPH test scale and living with the symptoms as best I can.

So, I would like to know about TUNA and TUMT, as I'd rather have milder side effects, even if I have to repeat the process after 5-10 years. Are these safe? What should I expect? And, finally, how do I find a doctor here in Medford Oregon I can get one of these procedures from?

Thanks

http://www.johnshopkinshealthalerts.com/reports/prostate_disorders/140-1.html compares TURP with TUNA and TUMT. Note that the relief of BPH symptoms is not immediate with TUNA or TUMT, and often has to be repeated every few years.