Google search for prostate cancer: Fixing obstructive problems? Good question!

What makes my book special ( I think ) is the attention that only a urologist who has been through the prostate cancer process and treatment could make of the voiding issues. That’s what urologists do…we are human plumbers. We understand how men void, the difference between obstructive (slow stream) and irritative (frequency, urgency, getting up at night) and the medicines and surgeries used for each. It is confusing. In my book there is a very large chart showing the differences in each and how all the treatments affect each.

I once wrote on a prescription pad the symptoms and the meds for each for another doctor. A year later, he pulled it out of his wallet to use to treat a patient in my presence and said, ” John, you just would not believe how many times I have used your little cheat sheet!”

Back to the question. Obstructive…i.e. an  enlarged prostate, slow stream, secondary frequency and nocturia, stop start stream, no pressure, small caliber…….”You can’t piss and run under it.”

If you have obstructive symptoms and want to do radiation you had better beware!

If you want radiation and you have obstructive voiding symptoms…you can fix the symptoms before but not after. Things don’t heal well after radiation.

So….you have big prostate and obstructive symptoms and you want radiation, particularly seeds….

• Microwave therapy
• Laser prostatectomy
• TURP
• Maximum medical therapy if with very good response

After the above…then seeds…in most cases of prostate cancer with favorable pathology, the delay of a month or so is not a medical issue.

When  it comes to obstructive voiding symptoms and a male that want to do radiation…..

“It is better to cure at the beginning, than at the end.”