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Heart problems and HT

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User
Posted 28 Dec 2022 at 20:46

Hi all,


I received my PCUK toolkit today and I want to say it is impressive, what a wonderful organisation!


However I am feeling a bit meh today worried scared and fed up.


a new concern is that the toolkit mentions potential risk if you have heart disease and other problems.


I was unlucky enough to have had  a heart attack in 2017 which required open heart surgery to repair my mitral valve. And a double bypass.  Scary stuff but all went well .


Now I am concerned that the MDT who gave their view of my treatment plan took this in to consideration?


I am feeling a bit down so maybe overthinking 


but has anyone had similar concerns  and / or issues?


Thanks for listening 


N


 

User
Posted 29 Dec 2022 at 00:22
Worth asking your consultant or specialist nurse, but my guess is that RT/HT has been recommended because your heart problem rules out surgery. Keyhole RP requires you to be tipped head down for a number of hours which puts a huge stress on the heart. We have had a number of men here who had HT despite heart conditions; you just need to monitored well.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 29 Dec 2022 at 06:49

Thanks Lyn, I wasn’t aware of that really interesting point.


I thought the RT/HT route was because of the N1 diagnosis but I will check with the nurse.


 


kind regards


N

User
Posted 29 Dec 2022 at 11:25
The N1 could also have played a part. I suppose the point I was trying to make gently was that the small additional risk of HT causing heart problems is far lower than the risk of early death due to untreated prostate cancer.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 29 Dec 2022 at 13:22

Lyn how kind of you 😊


no need to be gentle, I do believe you are right.


I am just a little frustrated by a lack of communication and or action from the hospital. 

N

User
Posted 29 Dec 2022 at 13:49

I had aortic heart valve replacement and a double bypass AFTER my PC Brachytherapy. This means that I had a dicky heart when the Brachy was done. My thinking is that after you have had a heart operation your heart is in better condition, maybe not as good as if you had no heart problem, but much better than before the op. I am not sure what the "toolkit" is but I would rely on what the consultant says. I think he/she is likely to say that not having the PC op is more risk and that it's not so invasive that the heart will be troubled.


Cheers, Otto  

User
Posted 29 Dec 2022 at 14:00
Otto, the "Toolkit" is the set of prostate cancer information sheets that can be downloaded, or ordered in printed form, from this website.

Best wishes,

Chris
User
Posted 29 Dec 2022 at 14:47

I agree Otto just for clarity I am not being offered surgery.


N

User
Posted 29 Dec 2022 at 17:16

Ok, understood. But I expect you want to know that you are not having surgery because of the heart problem, which only the consultant can tell you, maybe via the nurse. 


Cheers, Otto

User
Posted 29 Dec 2022 at 17:26

Otto, I may have mentioned this in another post but I think it is more to do with I am T3b/a N1


So it has already broken out and is in pelvic lymph nodes.


I have asked the nurse to clarify but that was what I was led to believe during a phone call last week


N

User
Posted 30 Dec 2022 at 06:50

Hi N,


I understand. I am T3c but its only escaped into my seminal tract. I am inoperable  because they already operated and they don't want to spread it. I am probably on the same drugs as you, a version of Zoladex. A note of optimism is that I am told there are new drugs coming out to help the T3-ers. I think we are called "local severe". It would be good  to get some input for T3-ers from our minders on Prostate Cancer UK, particularly on the drug outlook. Maybe we could have a T3 club here. We both have had roughly the same heart op, but that is probably irrelevant. 


Cheers, Otto

User
Posted 30 Dec 2022 at 11:26
Otto, the phrase is 'locally advanced' as in 'it is advancing in the prostate gland' .... 'severe' isn't used to describe cancer stages.

You are on Prostap I think, not Zoladex.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 30 Dec 2022 at 12:50

Well finally the system has got itself sorted out and today I swallowed my first tablet.


First injection of Prostap booked in for the 13th Jan


N

User
Posted 01 Jan 2023 at 05:48

Sorry, yes, locally advanced. A state of continuous trepidation.


Cheers, Otto

User
Posted 01 Jan 2023 at 13:31

For men considered at high risk of a coronary issue, Degarelix is sometimes used as the hormone therapy drug, because it has a slightly lower incidence of coronary issues. The risk of a future coronary issue isn't necessarily linked to issues you've had in the past and been successfully treated for. Something to discuss with your oncologist and cardiothoracic surgeon, and maybe to get some extra periodic cardio monitoring.


Degarelix requires 4-weekly injections, and they do tend to generate an inflammatory response at the injection site which may need additional treatments.

User
Posted 01 Jan 2023 at 14:57

Hi Lyn,


Happy New Year. I think you are right: I am on Leuprorelin (Prostap 3 DCS). Any tips welcome. 


Cheers, Otto

User
Posted 01 Jan 2023 at 19:11

thanks Andy


i checked and the MDT was fully informed of my history so I feel a lot more relaxed.


N

User
Posted 02 Jan 2023 at 00:25

Hi N, I’ve just been reading your thread and my husband has recently been diagnosed with PCa stage T3.  He has cardiomyopathy which meant surgery wasn’t an option which would have been the preferred choice with him only being 54.  Surgery puts a huge strain on the heart which is likely to be why they haven’t offered it to you either. My husband is on monthly prostap injections for 4 months then starts RT in March. Because of his heart, the oncologist has said they won’t be continuing with HT following RT due to the risk of cardiac issues. We’re feeling quite concerned about this but trusting their professional judgement as it’s all about balancing the risks. They will continue to monitor his PSA levels following the RT and will put him back on HT if they feel they need to. Definitely have a chat with your oncologist and explain your concerns, I’ve asked so many questions and they have always been happy to answer them. 

User
Posted 02 Jan 2023 at 10:00

Hi Nicola,


Sorry you find yourself in the club so to speak 😞


From your post it sounds like your OH and I are not quite in the same place. My heart was fixed through open heart surgery except clearly there was muscle damage that remains. 
I had all the scans and a PSMA PET scan which confirmed spread to lymph nodes. This is the reason I believe I wasn’t offered surgery.  To be honest I am kind of happy with that as I really wasn’t keen on another major surgery.
You didn’t mention if your OH had a bone scan? 


N

User
Posted 02 Jan 2023 at 10:46

Hi N, it’s not a nice place to be but I’m sure you are finding, like we are, that this forum is a great support. It does sound like your situations are slightly different, my husband’s heart muscle is also damaged but it’s his ejection fraction that impacts him (the efficiency of how your heart pumps blood around the body). I’m so sorry to hear it’s spread to your lymph nodes,  we feel my OH is in a fortunate position as his bone scan came back clear and from the MRI it showed no spread to the lymph nodes, but no further tests have been done to confirm this.   HT/RT is just as effective as surgery so I’m sure you and my husband will have a positive treatment path. I can’t remember if it’s been part of this thread or another thread I was reading (I read so many of them!!) but there is gentleman on here, and many more, who have been diagnosed with PCa with spread to lymph nodes and bones and they are still here 15 years on. It’s a worrying time for everyone but we have been finding the success stories really encouraging. 

User
Posted 02 Jan 2023 at 12:53

That’s interesting Nicola, it was the ejection factor that led to my op. It was down to 50% as due to the mitral valve being damaged as a result of the heart attack it leaked like a sieve and blood was being pumped back into the heart chamber instead of around the body. Wonderful surgeon in Bristol fixed it though 😀

User
Posted 02 Jan 2023 at 18:24

Oh wow, my husbands went down to 26%, they didn’t operate but he’s on numerous tablets and it’s now back working at 45%.  The heart is such a complicated thing!!  It sounds like you have made a good recovery but naturally you will feel very nervous about your treatment for PCa. Let’s hope you both bounce back from this too, life can be so cruel but keep staying positive 😊

User
Posted 02 Jan 2023 at 19:12

Why wouldn’t they give  OH surgery Nicola?


I was musing a little on this today and I have developed a bit of a hang up regarding exercise. Prior to heart isssue and surgery I would exercise without thought and push myself if I was in the mood but since I have this worry in the back of my mind that I may push too hard.  Maybe it is daft but the mind plays you.  I hope we get through the challenges of PCa treatment we may face and for me without developing any more hang ups, I suspect the erection/ sex elements will be the place most men dwell on, understandably we are just men 🤣

User
Posted 03 Jan 2023 at 07:22

I’m my husbands case it was severe heart failure and surgery wasn’t an option, his was caused through pneumonia which attacked the heart and has since left with cardiomyopathy.


My OH has an active job so apart from walking he doesn’t do any other form of exercise. They do say it’s important to exercise to build strengthen the heart muscle and it sounds like you are both doing great with what you are doing…just don’t push yourself too much!! We asked the oncologist about exercise and she told my husband he doesn’t need to do anything additional. 


I think you said you were starting on HT? Also, you’re considering Preston for your radiotherapy? My OH has been on it for a couple of months now and has already lost his sex drive and his suffering badly with hot flushes at night…a little fan has been helping with those!!  He is under Preston and so far they have been absolutely brilliant so hopefully you will have a similar experience 😊 

User
Posted 03 Jan 2023 at 08:16

Hi Nicola


yes I am on the tablets now , 1st Prostap injection due on the 13th 


I think I will wait and see how I react then invest in the fan if needed.  Forever the optimist.


Preston is the nearest RT centre to my home town although it is 60 miles each way!


I have emailed my nurse practitioner to chase getting the referral sorted. 

 
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