What is the "Transition zone"

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Don K.
Regular Member

Date Joined Jan 2010
Total Posts : 74
   Posted 1/13/2010 10:42 PM (GMT -6)   
Can anyone explain in layman's terms what the transition zone is in the prostate?
I'm still pretty new to this, am on HT and learning first hand about the side effects.
Thanks in advance.
...Don K...

Regular Member

Date Joined Dec 2009
Total Posts : 214
   Posted 1/13/2010 10:54 PM (GMT -6)   
Don welcome to the club with your first post.
This is what I found out about the transition zone on the internet:

The transition zone is the interior part of the prostate gland. The transition zone surrounds the urethra which carries semen and urine out of the body. After men turn forty, the transition zone (in addition to the central zone) begins to enlarge. The removal of the transition zone during prostatectomy due to prostate cancer can cause penile shrinkage due to the shortening of the urethra.

 I guess this explains why willy is not only completely limp at this point but also noticeably shorter after surgery.

Please tell us more about your situation and your stats.  You will find the guys here very understanding and helpful as we have all joined the club that none of us wanted to join.  The guys here are people you want to have around as you continue your PCa journey.


Age:  63 
Biopsy: May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason Score: 3+3.
RRP on Oct 23/09 in London, Ontario.  Excellent surgeon. 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.
Pathology:  Unremarkable 
First followup PSA and Visit: Feb 07/10.      

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4171
   Posted 1/13/2010 10:56 PM (GMT -6)   
There are three basic areas of the prostate, The peripherial zone has two lobes, the right and the left, and the transition zone that is in the anterior of the prostate and is the area that the ureatha runs right through it. It is hard to biopsy because it is deep inside.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 1/14/2010 12:58 AM (GMT -6)   
Here is a nice description of the 4 zones of prostate cancer detection:


Prostate Cancer Forum Co-Moderator

Don K.
Regular Member

Date Joined Jan 2010
Total Posts : 74
   Posted 1/14/2010 1:14 AM (GMT -6)   
Thanks for the quick responses Skeener & John.
Now I know where and what the transition zone is.
I started on HT (Lupron) 5 months ago and it has lowered my PSA from 38.3 to 2.4 at the end of 3 months. My next PSA will be in early March.
I had a Gleason score of 4+3=7 and the oncologist said it is a moderately aggressive cancer.
I am almost 80 years of age, in very good health and fly airplanes and ride a Goldwing Honda and participate in shooting sports.
The docs at Denver Uni Hosp want to start me on external beam radiation but it is a four hour drive each way to get there and I can't see myseld spending a week at a time in Denver for six weeks.
So I opted for the HT to buy a little time before getting aggressive on this beast.
The oncologist agreed to try the HT and even to go intermittant as long as the PSA stays below 1 or 2. He says that if I am lucky I may be able to just stay on and off the HT for years.
The side effects are awful! I have not had an erection for 2 months now and worse, my libido is down to zero. That is hard to take for me (even though I am an old guy).
I can tolerate the hot flashes OK and so far no weight gain or energy loss. That's another reason I hope I can go intermittent on this stuff.
I feel guilty whining about my little problem here as so many of you have a lot more serious problems than me. But I am kind of having to go it alone here as there is hardly anyone I can vent to.
Thanks again,
Don K.

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 1/14/2010 1:21 AM (GMT -6)   
you mention that you are 4 hours from Denver but Not sure in which direction. You also mention that you are going it alone and that certainly is not necessary if you don't mind groups. This site is great for support and caring folks. I also run a prostate cancer chapter of Us TOO Intenational. This is a live group that meets in every state and might be a bit closer to you for advice and education. you can go to www.ustoo.org and see if there is a local chapter near you. If you need any help trying to find one let me know and I will help you.

Prostate Cancer Forum Co-Moderator

Don K.
Regular Member

Date Joined Jan 2010
Total Posts : 74
   Posted 1/14/2010 2:29 AM (GMT -6)   
Thanks, that looks like an awesome site and will take me awhile to go through.
Unfortunately I live in Trinidad, CO right on the CO NM border and on I25 (on a good day) it takes me 4 hours to get to Denver.
I'm an airport manager (TAD) and it would be very difficult to run this place on weekends. It could be done but I'd sure like to find another way around this problem.
Tony, you have no idea how good it makes me feel to see yourself and others reaching out to me - A guy you don't even know.
The only thing I can offer in return is if you or any other members have any questions on airplanes or competitive pistol shooting, I may be of help. (or how to stay alive on a Goldwing Honda in heavy traffic).
Don K.

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 1/14/2010 6:49 AM (GMT -6)   

Greetings, Don.  Welcome to the forum.  One thing I have found about the folks on this forum is that even when we disagree  on a particular issue, we all know our underlying enemy is the cancer we fight and that far outweighs any other factor.  We are brothers (and sisters) who have a common enemy and will respond accordingly.  I've been hanging around for 2 years now and have a deep appreciation for the people here.  I keep telling myself that it's time to fade away since it looks like I'm well on my way to healing but at least for now, I keep being drawn back here and the main reason is the good people you interact with.  Glad you are here and keep us posted on how things going. 

By the way, the 81 year old mother of one of the ladies that works with me fell at 2 AM on new years day leaving a new years eve party.  She broke her shoulder and hip.  I told several people I hope that when I'm 81 and fall and break something it is at 2 AM leaving a party.  I may have to change that wish to when I'm almost 80 I can still lament the lack of sexual desire and drive off on my Goldwing.  Hang in there friend.  David

Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 1/14/2010 9:03 AM (GMT -6)   
Don, welcome to the Forum and glad to meet you. Like everyrone has said, everyone is welcome here, so find a place to sit and stay awhile.

After the greetings are done, they will probably be back to address some of your questions you asked... smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN

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