Turp! Is it in fact a legitimate treatment for metastazied PCA?

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logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5815
   Posted 5/29/2010 8:14 PM (GMT -6)   
Trying to make some sense of midi's post which looks like it sent some kind of record for responses. What do you all think? Did we all over react or was our reaction " justified " The Turp thing is really bothersome to me, so can someone, put some light on this for me!!
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 5/30/2010 12:19 AM (GMT -6)   
As a non-doctor, the only reason I can think of for a Turp is to clear the blockage so that one can urinate again. No way do I see it as any kind of direct treatment for PCa.

I didn't post in midi's thread, but didn't see any over-reaction there. Just good advice from concerned friends. Midi, if you are reading this, I wish you a speedy path to treatment and a favorable outcome.
Pre-op:
Age 63 at diagnosis, now 65.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve-sparing open surgery on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
25-month: 0.2 (yes, bummer)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. At 18 months, "graduated" to just the pump.


Gleason7
Regular Member


Date Joined Feb 2010
Total Posts : 111
   Posted 5/30/2010 4:10 AM (GMT -6)   
TURP and Midi
Midi has been all over the place with his maladies like bladder infections, constipation, HIGH PSA's, enlarged prostate???, and self inserted catheters several times a day. The story unfolded like his urologist was hung up on infections as being the bottom line plus his "enlarged prostate" (to me not all that large). A shame he has waited so long to have the biopsy and finally the CT and bone scans. Wonder if he was informing his urologist about his self catheterizations as it seems like doing so several times / day would cause irritation and swelling of the urethra. His latest posts suggest he may soon be getting to the source of the problem and I hope he has found a competent urologist.

midi
Regular Member


Date Joined Apr 2010
Total Posts : 122
   Posted 6/3/2010 4:38 AM (GMT -6)   
It got so bad finally had to go to the Hospital this week - still here for fourth nite but hoping to go home today. I had a fever, could not walk and yes waited too long to get a biopsy but Doc said I could've had it for years with no symptoms.

Feeling better & able to walk now and back to self-cathing.

I am now suffering from advanced PCa that has spread to bones and bladder - my only hope now is Casodex to reduce/relieve prostate/urinary symptoms and twice yearly hormonal therapy treaments to reduce the bone symptoms.

Hopefully I can live a few more years of a somewhat normal life to try to live again.

Don't know why I waited so long but the Docs kept telling me I just had an enlarged prostate.

Has anyone on here had any luck with the hormone treatments?
White Male 55
 
January PSA: 17.4
March PSA: 36.8
 
Cipro: three weeks
Macrobid: one week
Levaquin: 10 days
 
Cystoscopy: April 19th 2010
 
Self-cath still 4-6 times a day
 
PCa Biopsy performed May 17th 2010
 
Size: 54 grams
 
Gleason Score 4+5


Gleason7
Regular Member


Date Joined Feb 2010
Total Posts : 111
   Posted 6/3/2010 5:16 AM (GMT -6)   
Midi...Sorry but I have to give up! You said you were bleeding and had to go to the hospital because of your several times daily "self catheterizations" and here you go at it again. From my view you cannot continue on with this way of "life". If in fact a reaming is acceptable for those who have PC for sure you should pursue having it done. Your prostate at 54 grams isn't all that large since for me at 106 grams I was not having problems urinating and would still have my prostate were it not for PC. Would SEEM you should be having radiation treatments or removal of that very diseased prostate.

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 6/3/2010 5:17 AM (GMT -6)   
Just to set things straight. Midi did not wait too long to get a biopsy. A patient cannot walk into a supermarket and order a biopsy- especially if his only complaint is back pain. Midi was under the care of a doctor who's opinions he trusted. It is the doctor that might have waited too long. But hindsight is 20-20. Wasn't it John T that had 12 biopsies before they discovered the PCa? (Correct me if I am wrong.)
Midi, Hopefully your treatment is now on track.
Hormone therapy works until the PCa figures out how to eat something else. Then the therapy changes. Look at lving1963.
Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 3+4=7, 3+3=6. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. There must be another issue. Uro mtg 4/23.
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 12.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05, 4/14 9 months - 0.04 and <0.01 with ECLIA.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/3/2010 7:50 AM (GMT -6)   
Gleason7:

For the record, those people that have to self-cath, and that should only be determined by a good urologist, its not uncommon to have to do it 4-6 times a day at the min. Some do it more, some do it less, depends on urgency and bladder capcaity. It has to do be done right, as you can cause self inflicted damage and can cause UTI's to form. With me, my own uro said that I was not a good candidate to self cath, as due to all the conflict at my bladder neck, he was more afraid I would hurt myself. Plus, I have no intention of trying to stick a self cath catheter up my self, it would un nerve me too much with a full bladder aching to empty it self.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Gleason7
Regular Member


Date Joined Feb 2010
Total Posts : 111
   Posted 6/3/2010 12:03 PM (GMT -6)   
Purg and others I do stand corrected AND hang in there Midi!
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