Prostate Size Question..

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gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 4/6/2010 6:35 AM (GMT -6)   
Sorry for yet another question...
Long story short, I simply do not have the opportunity to speak with the doctors as often as I'd like, and thus don't get many of my questions answered...
My father's prostate is very large.....on of the nurses was doing an exam this morning (while putting a suppository in to help with constipation), and commented to me that she could tell his prostate was -very- big, that it felt like there was a softball in there....

We've had various folks tell us that IMRT won't necessarily shrink the prostate (and might do the opposite for a while)...
So if all goes OK with IMRT, what happens after that in order to reduce the size, which is currently causing all sorts of issues, like constipation by impacting the rectum, penis pain, pain sitting, etc.?
I'm assuming that removing it is out of the question, partly due to the fact that it would make all the radiation moot (no?), and the difficulty in removing after radiation. Would a TURP be done, and take out a ton of the tissue to reduce the bulk??

He's been on Lupron for 4 months, and while the Dr says he thinks it has shrunk a tiny bit, it really hasn't shrunk that much..

Thx again
Father 65 y/o at diagnosis November 2009
Gleason 9 & 10, stage 3 - seminal vesicle involvement
Two TURPs mid Nov. 2009
Foley Catheter
Casodex for last two weeks of November '09, then Lupron.
Suprapubic Catheter March 18th, but blocked right away, back to Foley...
Started IMRT March 25th, Chemo on hold due to catheter bleeding issues, etc.


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 4/6/2010 1:06 PM (GMT -6)   
Is the nurse really qualified to determine the size of a prostrate?

Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 4/6/2010 1:12 PM (GMT -6)   
Well, that wasn't really the point, we already know it is large based on ultrasound and MRI's. Approx. 8cm x 6cm...
Father 65 y/o at diagnosis November 2009
Gleason 9 & 10, stage 3 - seminal vesicle involvement
Two TURPs mid Nov. 2009
Foley Catheter
Casodex for last two weeks of November '09, then Lupron.
Suprapubic Catheter March 18th, but blocked right away, back to Foley...
Started IMRT March 25th, Chemo on hold due to catheter bleeding issues, etc.


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 4/6/2010 7:34 PM (GMT -6)   
Gibs,

Cannot comment with experience on a large prostate with IMRT effects, but rest assured that whatever problems your father is having already with BPH will only get worse after radiation ( at least for a time).

It is really too bad that your father did not have the option of a prostatectomy. With a prostate that large he would have gotten two or three benefits for the price of one.

No more BPH and it's annoying urinary symptoms .
Life sure is good for me now that my BPH is gone gone gone - almost worth the ED that came to stay in it's place -- but at least I don't have to Run To The Bathroom all the time for ED issues - hah hah hah).

I would hope no more TURPS ever -- ouch -- even the name sounds painful.

And hopefully no more PCa ( they routinely take the seminal vesicles in surgery anyways so no big loss there if that was the only escape).

Also the surgery lets the doc see the full extent of any extra-capsular invasives -- if any -- (how did they know about the PCA in the vesicles -- did they do a Biopsy there --ouch!)

And after surgery he'd would have had some time to assess the PSA: if staying at zero (no or little PCa escape) or whether if it was already on the move upward then HT and IMRT considerations and all that entails.

What was the original discussion about surgery? I know it is too late now for surgery and I am sure a Uro would never have suggested radiation (uros are surgeons - they want to surge!). Just interested in how much escape from the prostate there might have been to rule out surgery.
Age 59, 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
11/2008 Biopsy: 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery ,Nerve sparing, 1 day in hospital.
02/18/09 Cath out -- passed 1 cm oblong bladder stone (not kidney!).
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- (some tumescence 02-03/2010).
04/01/09, 07/07/09, 10/01/09, 01/15/10 PSA <0.1
08/09-09/09,02-03/10 MUSE@1000mcg (very little ache ) 80-90%
10/09-11/09 TrimixGel@(500/300/100mcg): 60,70,80%,
02/10-03/10 TrimixGel@1000/300/100mcg - 80-90% - just @ usefulness.
If Gel + MUSE 500mcg -- 100% for 60 mins and 80-90% for hours (good blood flow therapy for sure).

Post Edited (JimStars) : 4/6/2010 6:38:07 PM (GMT-6)

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