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Fears Over Prostate Cancer

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User
Posted 16 Sep 2022 at 19:49

Hi everyone, I'm new here as I've only just come across this site.

I'm a post op trans woman in my early 50's, I had my SRS almost 6 years ago now and post operatively everything has gone to plan. However, I started to notice about a year or two after surgery that there was a brown discharge from my urethra after I'd orgasmed, no pain or other symptoms, just the brown discharge which I can only think are dead blood cells. I spoke to my GP about this sometime soon after and she immediately did one of those urine strip tests but it came back negative.

I did my own research on Google around that time and found an interesting article written by some American doctor who had discovered there was a connection between the brown discharge and those trans women who also take Finasteride. I was on Finasteride at the time, had been for about 6 years previous for hair loss, so I immediately stopped taking it. The brown discharge seemed to go away a few months later.

However, I noticed as far back as 12 months ago that it's returned again and there seems to be more of it this time. Adding to this, there is cancer on both sides of the family, my step brother has recently been diagnosed with stage 3 prostate cancer but they won't do anything for him unless he loses weight. My dad passed away when he was just 43 so there's no way of knowing if he would've developed it later on.

Should I be worried? I'm trying to make contact with my GP for further intervention on this although I do have an untrasound scan appointment in 2 weeks for constant UTI's I was getting just after Christmas.

User
Posted 17 Sep 2022 at 02:07

You should be a little bit worried but not very worried.

Men who have had biopsy start with a red discharge (fresh blood) and it progressively darkens until a clears up (about two weeks). So my first question would be is there ever and bright red blood? If not it doesn't rule out blood and certainly needs investigation. 

You could have a PSA test, but a UTI would raise this So a high PSA would prove nothing but a low PSA would be reassuring. 

A digital rectal exam DRE would be through a different hole but the SRS could confuse a regular GP. However I think it would be a very good diagnostic test.

I assume you have had no testosterone for six years. As testosterone promotes prostate cancer not having any is good news. However if cancer had developed pre-op then it would eventually learn to thrive without testosterone. Being transexual is not a free pass when it comes to prostate cancer.

So I would say get GP to do a DRE and go from there, definitely don't worry about prostate cancer until you're diagnosed with it.

Dave

User
Posted 17 Sep 2022 at 07:30

Hi Dave and thanks for the reply.

In answer to your first question, no, there's never been any blood. There have been a few times though when I've noticed a faint brown staining in my underwear.

I was going to buy one of those home PSA test kits but my GP is one of those that prefers to see her own results and make judgment on that rather than anything else. I had 3 UTI's from Christmas last year all the way through to the end of January and they were really bad and needed 3 separate doses of antibiotics to clear it up. I'd only ever had very mild cases in the past but this time it was pretty horrendous. I had 2 major surgeries in December and January that were only 4 weeks apart and I can only attribute the UTI to my immune system being low after surgery.

Yes, a DRE seems the obvious choice I guess. I did speak with the nurse yesterday about a test for prostate when I went for my yearly blood test and she did seem a little confused about my question with the obvious reply that women don't have a prostate. This is when I had to declare to her that I'm trans and I definitely have one. She talked with me about the procedure etc and it's usually a rectal exam, of course that's not how you gain access to the prostate gland on a trans woman who's had surgery, you go through the vagina, the prostate gland basically acts as our G spot, the same as it is for other females. My GP booked me to have an ultrasound scan when I was going through all of the UTI issues but that appointment has only just come through, hopefully if there are any issues then this will get picked up on the scan.

With regards to testosterone I've not had any for over 8 years now as I had the testes removed in 2014 prior to my SRS in 2016. My T levels have been low since then, about the same level as any other female. I was self medicating on Finasteride from 2012 to prevent further hair loss and to help with its recovery but of course the same drug is prescribed to men who have enlarged prostate. I had major issues trying to get an NHS prescription from my GP because it's never prescribed to women but I've been off these now since around 2017/18 because I thought the brown discharge was related to it.

I'm totally with you on not getting a free pass. I often keep getting letters through for cervical smear tests because I'm registered as female on all of my NHS records. Obviously though I don't have a cervix but there is some talk out there that suggests that trans women can still be at risk from cancer of some type in the neo vagina. It's a minefield out there to be honest.

I left details with my GP yesterday for a telephone appointment. Remember the days of real face to face appointments? Hopefully she calls me back soon but as GP's and trans patients go she's actually pretty good with the whole situation.

Thanks again, Reena.

 
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