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Shrinking Balls Post Radiation Treatment?

Swingshiftworker
Posts: 616
Joined: Mar 2010

I've noticed that my testicles seem to have shrinked in size following CK treatment 2 years ago. This hasn't affected my sexual performance (no ED) but there has been a reduction in ejaculate (which was anticipated).

There are some articles on the Net that state that radiation can somehow cause shrinkage in penile length (but I haven't experienced that) and there are also articles that say that hormone therapy can shrink testicles (I haven't received any HT), but there doesn't seem to be any info on radiation causing shrinkage in testicle size.

Has anyone else who's received any form of radiation noticed any shrinkage in the size of their testicles?

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Kongo
Posts: 1167
Joined: Mar 2010

Swing,

Have not noticed any such thing in my case and the radiation pattern for CK is specifically designed to avoid the testes since it could have an effect on T-levels. I can't imagine that radiation to the prostate would have any effect on the size of the testes but I am meeting with my radiologist next week and will ask him.

Maybe you're just playing with them too much.

K

Swingshiftworker
Posts: 616
Joined: Mar 2010

Hey, Kongo: When I play w/myself, it's not w/my balls!

But, seriously, let me know if your RO has anything to say about this. It's not a problem for me; just curious if there's any known connection w/the treatment.

BTW, were you aware of the reports of penis shrinkage associated w/radiation treatment? We're both aware of the physiological effect of prostate surgery resulting in the reduction in exposed penile length but I never heard of the problem associated w/radiation until I looked into the shrinking testicles question. Apparently, EBRT and BT can cause a shrinkage in the urethra which causes shrinkage in penile length. This wouldn't be a problem for men treated w/CK since it can avoid radiating the penis. Not sure about IMRT but it should be less likely to cause this problem as well.

Just something else to warn men about before they decide on a course of treatment.

VascodaGama's picture
VascodaGama
Posts: 1504
Joined: Nov 2010

Swing

You have misinterpreted Kongo’s comment. It seems that He will inquire with his RO if playing with the balls makes them smaller.
Regarding the P “length”, I would think that such is part of the known RT “late side effects”. They occur 5 years later, shrinking on the average of 5 mm per year. LOL

VG

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Kongo
Posts: 1167
Joined: Mar 2010

Swing,

I hadn't heard of radiation causing penile shrinkage and haven't noticed anything different but then again, I'm not measuring it either. (Wait, honey, hold on a minute...I need to measure this thing)\

Since the urethra passes through the prostate I would imagine that if it does shrink a little from radiation it might have an impact.

Something else to ask the doc.

K

Timlong
Posts: 34
Joined: Nov 2011

My friend Tim mentioned penile shrinkage after his RP in late December. (at least half inch) I guess removing that section of urethra which passes through the Prostate gland and then pulling it back to the bladder neck causes this. Not sure what he will see (or not see) after radiation.

Jeff

hopeful and opt...
Posts: 1278
Joined: Apr 2009

will reduce or eliminate shrinkage.

Swingshiftworker
Posts: 616
Joined: Mar 2010

Loss of penile length following RP is a little discussed and often overlooked consequence of RP.

When I asked about this with one urologist/surgeon, he claimed that there was no loss in penile length. Technically, he's correct because the external length of the penis is unchanged BUT the length associated with the portion of the urethra is lost after RP and the external length is "sucked" into the body to make up the difference after the lower and upper ends of the urethra tract and tied together. The net effect, however, is the apparent loss of penile length as a result of removing the prostate.

Using a suction tube regularly can "help" keep the penis from atrophying if there's ED following surgery and can "help" to keep more of the external length of the penis visible BUT it is unlikely that suction will actually help to restore the length lost due to the remove of the prostate.

fredfred0028
Posts: 1
Joined: Mar 2012

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Beau2
Posts: 228
Joined: Sep 2010

Sorry you found Kongo's joke offensive. I did not.

I've been on this forum for a little while, and I can assure you that Kongo has provided extremely valuable PCa information to many a PCa patient that has helped them in their fight against PCa. I do not feel that Kongo had any intent to offend you or anyone else. I feel he was just trying to add some levity to a serious situation (PCa).

At times I make jokes about my PCa side effects ... levity helps me.

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Kongo
Posts: 1167
Joined: Mar 2010

Welcome to the forum, fred.

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

There is absolutely no way your CK treatment had anything to do with your shrinking ball syndrome. He did mention that they naturally tend to change size based on diet, temperature, and so forth. Ditto with penis shrinkage. Never been recorded.

K

Swingshiftworker
Posts: 616
Joined: Mar 2010

Ok, thanks for asking. Was just wondering.

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Kongo
Posts: 1167
Joined: Mar 2010

So, you ought to consider Scrabble instead of playing pocket pool. LOL

Swingshiftworker
Posts: 616
Joined: Mar 2010

Will do!

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

One other thing he mentioned during our chat that I found fascinating was that they are beginning to recognize that men who have a PSA bounce after radiation treatment have a much higher chance of never having a recurrence than those who don't have a bounce.

They haven't a clue as to why this might be and it seem contrary to what you might imagine. About 25% of men do have a PSA bounce and we mentioned it in the context of a slight bounce I had along the way where I went from a 0.9 up to 1.2 and then back to 0.8 on my last reading.

It doesn't mean that if you don't have a bound that you will have a recurrence, it just means that they've observed that much fewer men who do have a bounce have a recurrence. They don't know really what causes the bounce although most speculate that it has something to do with some last gasp cancer cells giving up the ghost. But he admitted that they're just guessing. Nobody knows for sure.

I thought that in light of your own PSA history after treatment that you might find that interesting and may want to bring it up with your own radiologist the next time you see him.

He said that the typical CK patient sees a PSA less than 1 by the two year point and that it continues to decline to about .2 to .5 in the next year or so.

He also indicated that there are several more studies coming out in the next year or so that will continue to confirm the good results recently reported in the Katz and King papers.

Best,

K

p.s. Sorry about the pocket pool crack, it was a low blow.

Swingshiftworker
Posts: 616
Joined: Mar 2010

Thanks for the info and the apology.

I just dropped below 2 for the 1st time in Dec 2011 -- 15 months after my CK treatment -- and am still hoping to get below 1 (or at least closer to that level) in March 2012 after my next PSA test.

So, I'm not even thinking about the "bounce" phenomenon yet (unless you're suggesting that my elevated levels post-CK -- there was one spike from 3.03 to 5.07 & back to 3.72 -- could be considered my bounce, which I doubt), but I'll keep it in mind.

howm
Posts: 1
Joined: Mar 2012

The PC thing is new to me. Just learned about it for sure two weeks ago. I am going to use CK treatment plan. Part of the decision was all of the positive information read on this blog. Had not seen anything about shrinkage before. Interesting...... best of luck to everyone.
In reading deeper into the blog saw that is norm to provide a bit more information about one's PC. I have watched my PSA since the early 90's always been in the 2.8-3.5 range. In Aug it jumped to 4.2. We tested again to avoid lab error and got a 4.3. Scheduled biopsy and just before had a PSA of 3.0. Had a nasty reaction to biopsy...major infection took two months to clear up. Initial Doc did not tell me anything other than it was cancer and this was on the phone! Went for a second opinion two weeks ago and they confirmed that it was cancer. Two nodes with a Gleason Score of 7. Ruled out the "watchful waiting" thing. Spoke with a ROC who recommended CK. Sounded good and here we are. Will have the gold things placed in two weeks. Saw an interesting thread about time between treatments. Good info.

hopeful and opt...
Posts: 1278
Joined: Apr 2009

got a second opinion on the pathology of your biopsy.....by an expert so you are not over or under treated.

Is your gleason 4+3=7 or 3+4=7?

What is the involvement of each core?

What is your age and general health like?

Generally CK treatment has been done on those with a a 3+3+6 gleason. There have been few treatments, as I remember with a low volume 3+4=7. (Hopefully others can add input to this point)

Swingshiftworker
Posts: 616
Joined: Mar 2010

Good luck w/your CK treatment.

A number of us here have already received it and the prognosis for us has been good. I believe all of us were Gleason 6 when treated but I don't see why it won't work for Gleason 7 as long as there's been no cancer migration. Alternate treatments are available if this has occurred.

Since you had a negative reaction to the biopsy, you should ask about a perineal placement of the seeds instead of transrectal (or at least get max antibiotics) before the placement.

Please keep us up to date on your progress in a separate and original thread.

jackiegleasonscores's picture
jackiegleasonscores
Posts: 24
Joined: Nov 2011

You guys are funny. I just read another thread where you all were in a remarkbly intricate detailed discussion. Now here you are half joking around.
Anyway you all helped me 3 or 4 months ago just before my CK treatments and I am grateful. Now I am about 10 weeks past treatment.

A real side effect I had after biopsy in September and still have, in fact it feels like it is heating up more, is one testicle gets very warm. And i'm not playing with just one!! But seriously I haven't gotten a reasonable answer other than perhaps there was some nerve damage during biopsy.

First PSA came back 6.43. Last one before Ck was a bit over 8. What do you men think of that 6.43 number. Onc. and Uro. say this is the baseline reading they will use from here. Next PSA In June.

Wayne

Swingshiftworker
Posts: 616
Joined: Mar 2010

Wayne:

Take a look at the discussion in the thread that I started recently entitled "Still Not Below 1" here: http://csn.cancer.org/node/237864.

Many men w/in 3-6 months of CK quickly fall below 1 but you and I are not among them. There is a suggestion that a long period of time to nadir is better than a shorter one but the critical indicator that most people seem to accept for post-radiation treatment is PSA 1 within 2 years.

I'm currently at 1.55 after 18 months and am still not below 1. Hopefully, you'll do much better.

Good luck!

VascodaGama's picture
VascodaGama
Posts: 1504
Joined: Nov 2010

The process to kill cancer cells with radiation is equal to everybody because it destroys or damages the DNA of the cells. The hit must be precise but throwing arrows in the dark does not warranty that they hit the defined target. Proper diagnosis is a must and success also incorporates a proper choice of the absorbed dose, which should be enough or superior to the sensitivity of the cell’s nucleus.
This concept in my lay opinion is what makes the results different among RT patients.

The worse scenario would be if the cell’s type in a patient is less radiosensitive so that it can replicate/repair the damaged strand. Interesting is that there are drugs (sensitizers) to inhibit DNA repair. This may justify what many doctors recommend for not taking anti-oxidants (opposite sensitizers) while on treatment.

Our scientists have worked to optimise the doses so that RT can affect the cell’s DNA to the extent required with the lesser prejudice to the healthier ones.
At the end of the line, it would help to have one’s DNA (genetic) profile and choose the Grays that are most proper to one’s type of cell treatment.

In present times there is no precise rule to say that your treatments have failed. As far as your PSA decreases you should think only in success. Time is the answer and you need to give it a chance.
Here is an old document you may find interesting in reading;
http://ocw.mit.edu/courses/nuclear-engineering/22-55j-principles-of-radiation-interactions-fall-2004/lecture-notes/ef_of_rad_on_dna.pdf

Best to you both.
VGama

jackiegleasonscores's picture
jackiegleasonscores
Posts: 24
Joined: Nov 2011

Seems like SSW and I have had similar first PSA results. Now that i calculated the time after CK, the first lab was done only 9 weeks after treatment. I suppose I will just have to be patient until next lab in June.
Best of luck to you too SWING, I think patience might be the appropriate watchword for you at this 18 month period. It seems the studies referred to above project a continued, accelerated climb after month 18. Let's hope this will be your path too.
Wayne Retired from the bus seat and AWAY WE GO !!!!!!!!

Swingshiftworker
Posts: 616
Joined: Mar 2010

Thanks, Wayne.

I'm aware of the data that predicts an accelerated decrease from 18-24 months and am hoping that occurs.

FYI, things have settled down a great deal recently on the PSA front for me, but my earlier post-treatment PSA history was unsettling to say the least. Here's a complete history, which illustrates the wild ride I've been on since I received my treatment:

09/22/10: Last of 4 CK treatments
12/03/10: PSA 12.30
12/15/10: PSA 9.48
03/23/11: PSA 3.03
06/14/11: PSA 5.07
06/20/11: PSA 3.72
09/12/11: PSA 3.56
12/23/11: PSA 1.81
03/26/12: PSA 1.55

The rise between 3/23/11 and 6/14/11 technically qualified as failure but the follow up a week later and the future decreases indicated that it was just a "bounce."

What scared me the most was how HIGH the PSA scores started out and how slow they seemed to drop, but I'm now at a level where I can actually hope that the treatment has succeeded in effectively killing the cancer.

The next 2 PSA tests will tell the tale and, as I said above, I have no choice but to wait to see what they reveal. Only time will tell . . .

Swingshiftworker
Posts: 616
Joined: Mar 2010

Vasco:

As you say, "there is no precise rule to say that your treatments have failed" but there are 2 currently accepted parameters for identifying possible radiation treatment "failure" justifying further diagnosis and/or treatment: 1) a PSA rise of 2 or more and/or 2) 3 consecutive increases regardless of level following radiation.

There is also no precise rule for determining "success" but a drop below PSA 1 within 2 years seems to be a generally accepted measure of a greater probability of success based on past studies. Doesn't mean you still can't achieve success if your PSA is over 1 after 24 months, but the studies show an increased risk for failure if you don't.

The answer provided by time could either be success or failure. After a wild ride, my PSA scores are now trending down and, if the accelerated decline seen in other patients between 18-24 months holds true for me, I hope to see a drop below 1 for me by then.

Only time will tell and I have no choice but to wait.

Ciao!

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Kongo
Posts: 1167
Joined: Mar 2010

Who says you can't have fun with prostate cancer? LOL Now a bunch of snarky quips came to mind on the hot ball phenomena but I'll pass, Jackie.

I have never heard of this condition but it seems to me that if you had nerve damage during the biopsy perhaps it is possible.

I think your urologist is taking the correct approach to establish the baseline and to go from there.

K

mrspjd
Posts: 688
Joined: Apr 2010

In the spirit of “Laughter Is Always The Best Medicine,” here’s what Jerry Lee Lewis has to say on the subject:

http://www.youtube.com/watch?v=7IjgZGhHrYY

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