(Very) Enlarged Prostate Treatment Options

There is a drug called Avodart that is being studied. One study" the reduce study" so far shows reduded progression of the disease among those diagnosed with low risk disease, as you have been. The drug also shrinks the size of the prostate, and I believe that the reduce study has surveyed men with large prostates since that can be a duel benefit. There are also other studies that are not as favorable, so the jjury is still out. You may wish to discuss this drug with your medical team.

Guidelines for active surveillance vary slightly. For example at Johns Hopkins, for low , low risk prostate cancer, it is less than 2 cores with 50percent or less involvement in each core, psa /prostate size ratio of less than 0.15 and a PSA of less than 10. Since you have a giant prostate your PSA is elevated. It appears that you are still a candidate for active surveillance, but I would speak with an expert in the fiield.

If you decide to continue with AS you may wish to consider this drug.

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A friend of mine with a prostate size of about 100, just had sbrt. He did not have any hormones before this radiation treatment. He had problems with urinating before treatment, and had to have a cateter after treatment. He has not had a catheter during the last two months(he had treatment 3 months before. He is told that the prostate will atrophy over time.

My hubby had davinci 4 weeks ago. His PSA was 8.5. All cancer was confined to the prostate and his Gleason score was downgraded fro a 7 4+ 3 to a 3+ 4 which I understand to be good he had never had major surgery so it was all new to him especially  the drain and catheter and he managed quite well. Drain and cath were left in 1 week. His surgeon had done over 1000 thousand of these and told us my hubbies prostate was 2 time the size of a normal one and was on his top 50 for difficulty. Don't be afraid of the surgery because it seems to be well tolerated.  We chose the surgery because he wanted it gone and to get a true reading of how bad it was and the flea sons score was better. We would have never know that if we did radiation plus he can always have radiation later if it ever show up.  I an not an expert on this but this is what happens to us. Good luck 

my prostate is large, about 80 g, and i suffer from normal bph maladies. was recently diagnosed with pc, gleason 7 and am scheduled for surgery on 10 april. i can't imagine living with a 190 cc gland. even though your gleason score is only 6, i would (note, this is a layman talking) opt to get that thing outta there, though it's amazing that with that large a prostate, you have "no urinary discomfort." I have to go just about every hour and always with great urgency. given that your father had pc...that's another indicator that getting rid of that thing might be wise. i would also offer that with that large a prostate, a biopsy could easily miss something. bottom line, i agree with your doctor. find the best, most experienced prostate surgeon you can and get rid of it. my guess is that with a prostate that size the robotic approach would not be recommended. my surgeon recommended open / tradition  surgery for me because my prostate is large, and it's small compared to yours. you are only 54, you should handle the surgery well, assuming you are in decent shape. there are no guarantees, but with a good experienced surgeon you are likely to be fine and you won't have that huge prostate to deal with nor the risk of further prostate cancer down the road..btw, i'm 68. good luck!