Utterly OT: Prostate Treatment

[Cynic]

Following the usual preamble route I had a mri followed by biopsy and bone scan. Turned out I had a very aggressive cancer in the prostate but it hadn't escaped from the gland. Possible treatments included radiotherapy, brachiotherapy, keyhole surgery, robot surgery (also keyhole) or traditional slice and open up. The radiotherapy and brachitherapy had similar success rates but if unsuccessful the scarring meant no furthe treatment would be possible. I decided keyhole working was not as certain to get everything out as traditional open up and see what's going on. Within a month I no longer had a prostate to worry about and as the cancer was aggressive I am on bi annual blood tests plus annual clinic for life. At 72 I can manage without horizontal gymnastics.

[Tim+]

Good luck. Aggressive prostate cancers aren?t often detected before they?ve spread and are often symptomless. I hope your luck continues!

Out of interest, did yours cause symptoms leading to investigation?

Tim

[Harry Bloomfield]

Cynic has brought this to us :

A few months back, I went through US scan, DRE, interview and questionnaire, then MRI, Final interview said no problems, just natural enlargement as you get older.

[spuorgelgoog]

I think most of us at the prostate worrying stage either have no opportunity to get a woman pregnant, or would rather it didn't (or couldn't) happen.

Only if they've been watching the wrong sort of watersports videos online

Owain

[Bob Eager]

I had HoLEP, and I'm very happy with the results. Minimal pain, and I was out by lunchtime the next day.

[Bill Wright]

Anyone who has had an operation for prostate cancer will then be having six-monthly PSA tests. Beware! If you have the blood taken at a different hospital or surgery to last time, the results could be extremely alarming. Different centres use different methods of analysis and the results are not calibrated together. It's utterly ridiculous but that's the fact of it.

Bill

[Brian Gaff]

Luckily I have no problems in this area, but yes, you are right most men who have had surgery have problems afterwards, apparently due to the formation of scar tissue affecting closure or diversion so to speak of what comes out! I guess its only to be expected I notice around my body where old injuries have healed that now being almost 70, the skin is harder and less pliable. However if the problem is you cannot pee, then what choice is there in the end. Brian

[Cynic]

In reply to Tim, I gradually developed a need to get up in the night to pee. Over a year or so and frequency increasing to three or four times only to produce a couple of tablespoonfuls I made an appointment with the local surgery. The receptionist gave me a sample bottle which I duly filled and left for checking. Later that afternoon I had a phone call to say they had detected traces of blood and an appointment made for the following day. Cue a visit and digital exam plus booking for blood tests, cat scan and see a specialist at local hospital. The gp put me on a muscle relaxant at that point which took the edge off the feeling of urgency for a while. Following the first visit to the specialist I was put on tamulosin which almost made me normal again. This accompanied by regular psa blood tests. After about a year symptoms were coming back and psa rising again which was the cue for the MRI, biopsy and bone scan. I recall seeing the specialist a few days later and being given bad news "you've got aggressive cancer" followed by good news "It's still contained within the prostate" rapidly referred to the surgeon and off we went on the selection of option and radical prostatectomy. Three years later and I'm still fine, able to do most things, look after our village hall and I still ride my horse. Took me a few weeks to get back up to speed of course.

[tim...]

I don't even have cancer and I still have my body compete including the extra bit that I don't need)

but I have to undergo that inconvenience

"just in case"

tim

[Brian Reay]

Your experience sounds much like that of a very good friend of mine. Although, as I recall, he had some kind of small inserts placed in, or near, the prostate for a while which (I assume) killed the cancer. That must have been 8 or so years back and when I last saw him (he doesn't live in the UK, although we converse regularly), he was fighting fit. He is about 70 and very active.

His experience made me request my PSA be checked as part of my annual 'MOT' the GP surgery does - which happens. However, the GP did comment is isn't the most reliable first indicator.

I hope you stay fit.

[tim...]

Not all symptoms are ones that you think you need to do anything about

I first experienced "slow flow" which I assessed because I was spending longer than anybody else at the office urinal. But I just put it down to general effects of aging (at less than 50!)

So when I got to 50 (and a bit) and was called into the doc for my "well man's assessment". Along with all the "do you get enough exercise" nonsense they just took some blood which they sent off for testing without explanation.

A week later I got a call from the hospital to make an emergency appointment because my PSA was 6. "Um my what is what"? "I know nothing about this" (but I digress)

So, at this appointment I was given the form to fill in to see how I "scored" for symptoms and I thought "I've had all these for 3 years and didn't give it a second thought"

I scored 10 out of 10 - different hospitals have different questions on their form, I always score 10 out of 10

Tim

[TOJ]

It depends on how well the op went and whether you can pee after they take the catheter out. I had the op on a Friday afternoon and went home on Saturday afternoon.

[tim...]

Its a reliable indicator for an enlarged prostate

which is not a reliable indicator for cancer

tim

[Bob Eager]

It's the rate of change which is important.

[Brian Reay]

You may well be correct, would that be spotted without frequent testing? My GP suggested other symptoms were generally the first signs, if you knew what to look for. Having said that, like so many things, if you spend your life worrying about every tingle, twinge, etc you probably will die of some stress related ailment ;-)

[Bob Eager]

No, I am still tested every six months.

[Tim+]

Luckier than my friend who was in his 50s. No urinary symptoms at all, just a bit of hip pain that he put down to over-exercise. Scans showed widespread bony mets. Dead in under a year from diagnosis.

Tim

[GB]

I think it's the usual problems with change. There are 15000 TURP operations done each year (according to NICE), and the NHS has the facilities and trained staff to do that many.

There have been a couple of thousand PAEs done in the UK in total over the last few years - see the ROPE study. To gear up to do more PAEs will need more radiologists, with the right training and experience, and completely different facilities.

So, there's a long transition period during which the majority of patients will have to have TURP.

Absolutely agree, Tim.

[Peter Johnson]

Tamsulosin, which relaxes the muscle, can be prescribed with Finasteride, which should reduce the size of the prostate. It works on the testosterone. (Google Finasteride and you will get any number of responses related to hair restoration.) Having been on both for 12 months without any consistent improvement I have an appointment to see a consultant on 12 September.

A couple of links that might be of interest:

[Bill Wright]

On 14/07/2019 10:07, Cynic wrote: and I still ride my horse. Took me a few weeks to get back up to speed of course.

Who had the op, you or the 'oss?

Bill