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First Zoladex no change

User
Posted 21 Jul 2019 at 13:05

Hello I am 83 years old and my father died of pca in 1953.

my PSA reading was 134. Because of other health conditions I couldn’t have a biopsy or any treatment other than hormone therapy. I had my first Zoladex injection on July 4th and hoped for some relief from symptoms quite quickly. However I am still peein hourly day and night. I have just finished a course on antibiotics for a UTi.

I just want to touch base with others going through similar problems.

Thanks

User
Posted 21 Jul 2019 at 14:39
H, if tumour was causing uretha obstruction then Zoladex needs more time to reduce tumour sufficiently. Hopefully when your UTI s cleared up that will help. Don't hesitate to go back to medics if it hasn't.

Ray

User
Posted 21 Jul 2019 at 19:56

Rabbit63,

You haven't given much detail about your diagnosis, e.g. any MRI or bone scans? Size of prostate?

A PSA test taken while you have a UTI is not useful either.

On what basis did they diagnose prostate cancer?

What volume (in cc's) do you pee when you are peeing frequently? (pee into a measuring jug.)

You might want to lookup Pelvic Floor Exercises and bladder retraining.

Zoladex might take 3-6 months to shrink an enlarged prostate, if that's what is causing the urgency. I think there's a drug to prevent bladder spasms, which might help much more quickly.

 

User
Posted 21 Jul 2019 at 23:07
Sorry my first post so didn’t know what to share. I had clear bone scan and MRI showed local spread to seminal vesicles. PSA was 134. Rectal examination indicated nodules on prostate. I had private consultation following flexible cytology which showed no bladder cancer. Mt urethra is very constricted and I only pee tiny amounts at a time. I can’t have a biopsy because of the colitis and radiotherapy is counter indicated for the same reason.

Consultant prescribed 8 weeks of tablets (began with d but can’t remember name) to improve flow to no effect. I had two weeks of tablets befor and after first Zoladex to prevent ‘tumour flare’.

User
Posted 22 Jul 2019 at 00:16

A handful of hospitals now do an outpatient transperineal version of the transrectal biopsy. (This is not a template biopsy, which although also transperineal, is not an outpatient procedure.) However, it doesn't sound like it's very useful to know your gleason score, so probably no point.

Tamsulosin is a drug used to improve flow - you might ask if you can try it, or if it might be a problem with other conditions or drugs you're on. It's effect usually shows within 1-2 days, so you would know well within a week if it was going to be useful for you.

You mention slow flow and UTI. UTI's can be caused by failing to empty your bladder each time you pee, which allows any bacteria in the bladder to remain and build up again. If you aren't emptying your bladder every time, you should try practicing double voiding. This means after you peed, you wait half a minute or so, and then pee again. If necessary, keep doing this until you have emptied your bladder. It is often easier to do this if you sit to pee.

User
Posted 22 Jul 2019 at 10:41
Thanks for that I’ll give it a go.
User
Posted 22 Jul 2019 at 11:21
When I had "flow" issues during radiotherapy (a very common side-effect - the radiation makes the prostate swell up and obstruct the urethra), Tamsulosin worked wonders for me. Do give it a go if your medical conditions allow you to take it. The main problem you're likely to encounter with it is that it lowers the blood pressure, so if you're already prone to low blood pressure you may not be able to take it.

Best wishes,

Chris

User
Posted 22 Jul 2019 at 14:15
Yes low blood pressure, ulcerative colitis, diabetes, heart disease and prostate cancer! The colitis seems to cause most problems for treatment .
User
Posted 22 Jul 2019 at 19:37

Inserting a spacer between rectum and prostate is done for some people with bowel problems so they can have radiotherapy and avoid the rectum getting much dose. SpaceOAR is one make of gel used, and other options are balloons.

User
Posted 22 Jul 2019 at 23:28

Thanks Andy I will speak to the team at the hospital about that. I was told that, at my age HT was probably the best option but I will consider anything. 83 is pretty old to most people but to me it’s just the age I am. I’d like to enjoy life for a while yet if possible. 

 
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