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BPH and Prostate Volume

Hunt2871
Posts: 10
Joined: Mar 2018

So I like the idea of brachytherapy as a treatment option and had decided I would start treatment this coming fall but my urologist says I have a large prostate by volume and it would have to be shrunk with hormone treatment.  This is based on DRE's and an MRI so it is indeed larger than it should be.  I have decided against brachytherapy because the memory and cognitive side effects of hormone therapy are things I can't live with.

I asked my urologist PA about BPH and he dismissed it  out of hand, as a possible reason for my enlarged prostate but my perusing of the internet has lead me to think I could have something other than the cancer causing my enlarged prostate.  Has anyone any experience with BPH while also having cancer?  This is possible, isn't it?  Isn't BPH kind of normal as men get in their 50's? 

 

How is BPH diagnosed and treated?  I haven't had a urine test in 3 years and my current uroligist said if it was BPH that was detectable with a urine test that I'd have other symptons like fever etc. but from my reading on the net it seems that fatigue and other symptons could also indicate the presence of an infection or BPH.  I work 12 hours a day 5 days a week and drive a little over an hour each way....I am fatigued and have very little energy.....I have flow issues, especially when I do not urinate as soon as I feel the need and I usually have to kleagle several times to fully empty my bladder.  If my prostate is enlarged due to BPH can it be treated first and the hormone treatment to shrink it be avoided?  Anyone have any experience?

Clevelandguy
Posts: 460
Joined: Jun 2015

Hi,

From what I have learned what your doctor prescribed is the proper treatment for your brachy treament, the Urologist wants to get the enlarged prostate down to a “proper “ size before they implant the seeds.

Dave 3+4

eonore
Posts: 50
Joined: Jun 2017

It is entirely possible to have cancer and BPH.  In fact it is not uncommon for men to seek treatment for BPH and urinary problems and as a result of the consultation, find out they also have cancer.  In my case, I required treatment for my severe BPH, and that made my treatment choice for my cancer easy.  Out it came, no more urinary problems.

 

ASAdvocate
Posts: 116
Joined: Apr 2017

There is no prostate size limit with high dose bracytherapy. The limit only applies to seeds, not HDR-BT.

 

Find a practice that does HDR-BT and have a consultation with them.

 

Clevelandguy
Posts: 460
Joined: Jun 2015

Hi,

If your doctor says there is a need to shrink your Prostate to treat using Bracy then the doctor must have a reason. You should talk with your doctor and find out why the need to shrink your gland first.  I doubt the doctor is doing it for grins and giggles. 

Dave 3+4

Sw1218's picture
Sw1218
Posts: 55
Joined: Jan 2016

hi, yes. it's VERY possible to have not only BPH and prostate cancer, you can have BPH, prostate cancer AND prostatitis all at the same time. how do i know? because that's what i have. my diagnosis of BPH and prostatitis came as a result of a biopsy. doctors will prescribe a medicine like flomax to treat your urinary symptoms.  i'm not sure if there's another way to diagnosed BPH besides a biopsy. 

a urine test may detect BPH, but i don't know how accurate that claim is. i wouldn't just take the doctors word for it. i would encourage you to do your own research. fatigue is not a symptom i experience, so i can't speak on that. if i'm not mistaken, infection would more likely be prostatitis. i'm not sure how your docs will address your BPH with respect to cancer.  

 
Grinder
Posts: 441
Joined: Mar 2017

Like SW1218 I had ALL THREE  at the same time.... Gleason 6 PC, Prostatitis caused by a recurring Staph infection that would periodically cause my prostate to swell up to massive size and shut down my plumbing, and BPH to keep my prostate around 200cc when I was not suffering a prostatitis attack.

My normal routine was Cialis in the morning and Flomax at night just to be able to pee at all. That worked OK until the infection would flare up, at which point was a trip to the emergency room. Self-catheterization could not get the tube past the pinching off prostate and bleeding. The next two weeks were using a Foley and antibiotics to knock down the infection... until the next attack which were occurring more frequently... From every couple years to three times a year. 

My PSA would go up to 9 then go back down to 4 or 5. But then in 2016 it soared to 18 and stayed up, so a biopsy was done and found the PC. 

OF COURSE I elected to have a prostatectomy. Since antibiotics were not eradicating the staph infection completely, I did not want to live the rest of my life taking Flomax or having a Foley catheter in or self-catheterization and drawing blood every time. 

I should mention that the Staph infection hiding in my prostate would inflame my urethra so a catheter felt like a hot poker going through my business. So I opted for a one time Foley poke instead of several a day. I actually had to hold ice cubes on my business if I wanted to pee once the Foley was out.

Maybe people can start to appreciate why Radical prostatectomy was a blessing for me.

But enough about that... you can have a urine test done to test for infection related prostatitis. As far as shrinking the prostate they recommended shrinking mine before the surgery, but I had the 2nd best surgeon in the area and he was not concerned. As long as the infection didn't flare up before the surgery it would be ok. Fortunately it did not, and the prostate was only 197cc in the post-op report. Normal size is 25cc. So that gives you an idea how large it must have been during the prostatitis bouts.

Here are the symptoms of my prostatitis from the recurring Staph infection ...

Flu like symptoms of nausea and sweating, a UTI that would cause painful burning in the urethra, inability to urinate for 12 or more hours until the bladder was distended to the point of an emergency room trip, disorientation, blood in urine, which was much worse when being catheterized, PSA shoots up to 9, and probably some more I forget about. Most prostatitis attacks are not as severe as mine... a Staph infection is one nasty bug to get rid of... And my BPH just made the infection worse. Add Prostate Cancer and you have the cocktail from hell.

So yes, I got an RP. That was a no brainer. 

 

Georges Calvez
Posts: 295
Joined: Sep 2018

Hi there,

Early on in my prostate cancer journey I had an ultrasound, it is cheap, painless and pretty noninvasive, probe up the bottom with plenty of lubricant.
I have the file with the pictures, you can see my bladder, prostate etc and it was possible to roughly size my prostate from the pictures, when it was hooked out it was close to the calculated size.
Here is an interesting paper on the subject;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842183/

Best wishes,

Georges

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