Prostatitis and localised cancer which treatment ?ha

User

Posted 09 Aug 2016 at 17:39

Hi all ,
First time on here , glad to be able to seek some help with a decision that has given me many sleepless nights!
I have had Prostatitis symptoms from an enlarged prostate since February this year, went to see a consultant in March had a PSA 6.8 he prescribed Ofloxacin 400 mg after 8 weeks no improvement retook PSA 7.5 then had Biopsy not expecting to find anything but came back positive for cancer Gleason 3.4 and in both sides,thankfully an MRI showed the cancer to be within the prostate ,

I have been given the choice of either nerve sparing robotic radical prostatectomy or ETB , has anyone suffered with Prostatitis symptoms before having either or these treatments , if so I would really appreciate some feed back , I really do not want to make my situation worse by choosing the wrong one !! I know the main objective is to rid oneself of the cancer but my immediate concern is the discomfort from the Prostatitis it is relentless. Thanks , Jan

User

Posted 09 Aug 2016 at 19:06

Hello Jan and welcome to the site

Your results are "good" in that Gleason 3+4 is better than 4+3 believe it or not and that the cancer is confined.

Were you advised about any other treatments available to you, ie Active Surveillance? Perhaps living with a cancer inside you and monitoring it regularly wouldn't do for you. Not everyone can go that route.

Is the consultant advising then that RP or ETB will rid you of the Prostatitis?

If you go to Publications on this site you can download The Toolkit, a set of useful leaflets on various treatments etc.

I'm sure others will be along to add their experiences to the mix so hang in there, it shouldn't be too long.

All the best

Sandra

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We can't control the winds - but we can adjust our sails

User

Posted 09 Aug 2016 at 20:03

Hi Sandra ,thank you so much for your quick response ,
No , active surveillance was not given as a option , I am not sure why ,perhaps the nature of my biopsy gave concern , I could live with surveillance I don't have a problem with that ! But as I said not given as an option .
And with regard to advise on the Prostatitis none really , thats why I have asked the question , wether anyone has had Prostatitis at the time of treatment either NSRRP or EBRT and what was the effect on it , there seems to be no information on this anywhere , I know there was a clinical trial
started in the USA in 2008 assessing the effect of RP on Prostatitis but cannot find any publication on the result .
My personal feeling would be if you remove the prostate you remove the problem but this may be a bit simplistic , but my consultant did have one pearl of wisdom ,he stated " if we remove the prostate and you still have pain we'll know it wasn't the prostate causing the problem ! "
Kind regards Jan

User

Posted 10 Aug 2016 at 16:26

Hello. My other half was diagnosed with prostatitis within a few weeks of his biopsy. We are assuming the biopsy caused it. But possibly could have been there beforehand but no symptoms.
6 months later he underwent brachytherapy, in hindsight I really think he should have made sure the prostatitis had gone before treatment. He has had prostatitis since bracy with pain on sitting and burning when he wees. We are 18 months on from brachy and at wits end as symptoms are getting worse. He has been on antibiotics for about a year out of the last 18 months.
So I would try to make sure the prostatitis is clear when you have treatment.

User

Posted 11 Aug 2016 at 00:37

Thank you so much for your reply , I am so sorry to hear of your partners situation and I truly sympathise , Prostatitis is an extremely painful condition and it appears to be extremely difficult to treat , It is basically an inflammation of the prostate and surrounding tissue and I agree that the biopsy could have either started the problem or aggravated an already underlying one , what a nightmare !
My consultant prescribed antibiotics but also told me to take pain relief everyday ,I also try and keep the pressure off when sitting by using an orthopaedic ring this has enabled me to continue to work.and walking that helps but only if you are feeling up to it .
I will take your advise , I have not been offered brachytherapy as my prostate is to enlarged but before undertaking radiotherapy I think the Prostatitis needs to be sorted but I think that may take sometime , I have been considering the RP surgery with the view that if the prostate is removed the pain will stop but no one can confirm this !
I hope your other half's condition improves , I have only suffered with this since February and it been dreadful so god knows how he must be feeling , god bless you and stay safe ,

Jan

User

Posted 11 Aug 2016 at 10:00

What with the prostatitis, and the cancer being Stage I (entirely within the capsule), I'd tend towards surgery; but for me, the acid test would be the reassurances from the Surgeon and the Radiotherapist about long term effects.

The key is to ask lots of questions, and take notes - not that you'll be tested later, but the act of note taking concentrates the mind!

DISCLAIMER (!): I was diagnosed with a stage II (capsule breached), and opted for radiotherapy, as the risks of nerve damage/incontinence appeared too high with surgery. Touch wood, it was the right decision for me!

User

Posted 11 Aug 2016 at 10:49

Hi Andrew ,
Yes without the Prostatitis problem . I would probably have EBRT because as you say the risks tend to be slightly less than with NSRRP , but I feel that the radiotherapy may inflame the prostate even more and that is the discussion I will be having with the oncologist ,
As with all of this no one seems to have any finite answers , wouldn't live be easy if everything was straight forward , hay Ho !
Thanks Andrew
Kind regards Jan

User

Posted 14 Oct 2016 at 08:41

Hi FishermanJan

Your query is a bit aged but I'm new to the community too so have only just seen it; hope the following helps.

Around the time you posted (Aug) I underwent a RP. In the 18 months before I had suffered from (undiagnosed) prostatitis symptoms, and in the 3 months between PCa investigations starting and me being treated, the symptoms were very much worse (coccyx and hip pain particularly). I understand this is a reaction to the DREs and biopsies.

I was told that after the OP these symptoms would abate and to a large extent they have. They've not gone completely yet at +7 weeks (which I too find strange as there's no prostate to be inflamed or angry) but they're definitely of lesser intensity and less frequent.

I guess by now you may have made your decision anyway, and would value hearing about it when you feel able.

User

Posted 14 Oct 2016 at 09:02

~Welcome to the site SumDumBloke.

I'm sure the information you posted will help somebody else even if FishermanJan doesn't see it.

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We can't control the winds - but we can adjust our sails

User

Posted 14 Oct 2016 at 09:17

Thanks for the welcome. I've lurked in the background absorbing information since my journey began, and am very grateful to you all for the help. I'll probably introduce myself a bit more fully, but for the moment thanks again.

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