Hi Mark.

I am not a doctor but I had surgery for prostate cancer back in 2010.

Please can you tell us your PSA value before you started on Tamsulosin and the latest value. 

Initial PSA measurement was 5.20, repeated 3 months later at 4.75.  MRI indicated prostate size as 85 cc.

Thanks for sharing that information. I'm not a doctor but I hope I will be able to give you some reassurance, although in medicine there are no guarantees, just probabilities.  I was diagnosed with early stage prostate cancer back in 2010, and had a radical prostatectomy.  I am an active member of my local prostate support group, and I've heard a lot of stories. 

A PSA of 5.20 (reducing to 4.75) is definitely worth checking, but most men in this position don't have prostate cancer.

You have had an MRI, which I think was most likely a "multi-parametric MRI" (also written as "mpMRI").   One of the things that makes the MRI a powerful scanner is that it is possible to modify the way it scans ("parameters") to pick out various types of tissue.  This ability can also be enhanced by the use of a contrast material (usually based on gadolinium) which is injected between scans.  The mpMRI is a reasonably new protocol which is designed to pick out suspicious regions in the prostate which can then be targeted for biopsy.  However, if no such regions are found on the scan, then it is a really good indication that there is no cancer to be found.  Of course, that doesn't prevent cancer spontaneously forming later in life, which is a bridge you may have to cross later.  

If I were in your situation then I would be reassured that there is no cancer right now, and I would happily continue on the Tamsulosin, particularly if the tablets are relieving the symptoms.  Unlike Finasteride, Tamsulosin doesn't artificially lower the PSA and hence doesn't lull one into a false sense of security.  I would ask for a PSA test every 3 or 6 months, and while it's around its current value, then I would get on with my life. 

As far as I know, a TURP does not make prostate cancer spread. I haven't heard of anyone even suggesting this as a possibility, but if this is worrying you I would seek advice from someone suitably qualified. 

Can I also say from my own experience that prostate cancer when caught early is a complete pain in the backside, but you can get through it and enjoy life afterwards. So, don't let the prospect of a possible future diagnosis prey on your mind.  Just keep monitoring your PSA and being "cancer aware". 

Thank you, Telemando. I appreciate the thoughtful message very much.

You're most welcome. We all like to help. Don't hesitate to post again if you need us!