Hi from a visotor from the colorectal board

ron50

     G'day all, my name is Ron I am from East coast Australia. I am a 15+ year survivor of stage 3c colon cancer into 6 nodes. I got lucky I lost a piece of transverse and descending colon and had 48 sessions of chemo over a year and fortunately I have been cancer free ever since. I can't say that It has not cost me as I suffer from several auto immune problems the worst of which is nephrotic syndrome. I lose up to seven grams of protein a day thru my urine. I have been under several different nephrologists and between them they have done three kidney biopsies. Unfortunately although they all show problems, none of the problems relate to any known kidney disease. I am 65 next birth day. In 2008 when I saw my first nephrologist he did an ultrasound of my kidneys , bladder and prostate. My kidneys and bladder showed no obvious problems but it was noted on the scan that there was significant prostatism. My prostate was described as enlarged with an estimated volume of 46cc and could be seen indenting my bladder. Everyone assured me that it was normal in a man my age and there was nothing to worry about. Not a line that comforts a stage 3 cancer survivor. I asked for a psa test and it came back at .043 so that satisfied me. I was told to keep an eye on it as even benign enlargement can cause problems.

       I am in a situation now that due to some painful auto immune problems, grade 2 ankylosing spondylitis, psoriatic arthritis and severe motor sensory peripheral neuropathy of both legs I have been put on opiate pain killers. It is an interesting drug called targin , it combines oxycodone with the opiate antagonist naloxone. Apparently it is impossible to get high on them and the noloxone is also supposed to stop opiate induced constipation. I can attest that it doesn't. Each time I take a targin I have to take two dulcolax to reinstate bowel motility and three coloxyl to keep things soft. It seems to be working . Given that in 2008 I had an enlarged prostate my doc orderred another ultrasound to make sure my prostate was not bkocking off my colon. When I read the report I had a bit of a wtf moment. My ultrasound showed that my prostate was completely normal and within size limits at 28cc. So in 6 years it has shrunk from an estimated 46cc to an absolutely normal 28cc. It quite astonished me , I have never heard of a prostate shrinking with age. I was just wondering if any of you gentlemen can shine any light on the situation. I wonder if medications have a bearing on it. For the nephrotic syndrome I am on 150mg daily of cyclosporine. Thanks in advance for any help you can give me, wishing you all the best health possible. Ron.

VascodaGama

A lay opinion about the size of your prostate

Hi visitor,

Normal sizes of prostate differ with age. Your 46 cc in 2008 (59 years old) could be considered normal, though enlarged. This occurs due to the BPH which is a natural factor of aging. However, the decrease to 28 cc at your 65 years old seems to indicate that the previous enlarged measurement may have existed due to infection or inflammation (UTI, etc). I am not aware of your treatments along the 6 years but any antibiotic or medication that treats inflammatory conditions could have treated the temporary condition of 2008.

BPH condition is treated with drugs of the group of 5-Alpha Reductase Inhibitors. These interfere with the metabolism of androgens (testosterone) which is said to be behind the reason for the increase in the number of prostatic cells (benign in this case) that enlarges the size of the prostate. These drugs are also used with success (in some cases) to reduce the size of enlarged prostates before radical treatments for prostate cancer. I wonder if the drugs you are taking have hormonal effects.

The PSA of 2008 at 0.043 ng/ml is within the normal range for a 59 years old man. In fact the level of PSA also increases with age and it could be as high as 3.5 ng/ml for you. But the PSA may lead to erroneous judgement in terms of cancer if we base the decision in only one test result. The trend of several tests (PSA) is required to have some sort of assurances and peace of mind.

I wonder what your PSA is now. It should be lower because of the reduced size of the prostate. Any increase should be taken seriously.

Best wishes,

VGama

 

ron50

VascodaGama said:

A lay opinion about the size of your prostate

Hi visitor,

Normal sizes of prostate differ with age. Your 46 cc in 2008 (59 years old) could be considered normal, though enlarged. This occurs due to the BPH which is a natural factor of aging. However, the decrease to 28 cc at your 65 years old seems to indicate that the previous enlarged measurement may have existed due to infection or inflammation (UTI, etc). I am not aware of your treatments along the 6 years but any antibiotic or medication that treats inflammatory conditions could have treated the temporary condition of 2008.

BPH condition is treated with drugs of the group of 5-Alpha Reductase Inhibitors. These interfere with the metabolism of androgens (testosterone) which is said to be behind the reason for the increase in the number of prostatic cells (benign in this case) that enlarges the size of the prostate. These drugs are also used with success (in some cases) to reduce the size of enlarged prostates before radical treatments for prostate cancer. I wonder if the drugs you are taking have hormonal effects.

The PSA of 2008 at 0.043 ng/ml is within the normal range for a 59 years old man. In fact the level of PSA also increases with age and it could be as high as 3.5 ng/ml for you. But the PSA may lead to erroneous judgement in terms of cancer if we base the decision in only one test result. The trend of several tests (PSA) is required to have some sort of assurances and peace of mind.

I wonder what your PSA is now. It should be lower because of the reduced size of the prostate. Any increase should be taken seriously.

Best wishes,

VGama

 

Thank you for

   Taking the time to reply to my question. the one thing that I have learned from dealing with cancer is that you can never learn too much ,Thanks again Ron.

ron50

ron50 said:

Thank you for

   Taking the time to reply to my question. the one thing that I have learned from dealing with cancer is that you can never learn too much ,Thanks again Ron.

I asked my nephrologist if he was aware of anything that would

Reduce enlarged prostae, Off hand he knew of a couple of meds that may reduce prostate size. Then he came accross an old article from the days that cyclosporine was being tested on rats for potentially dangerous side effects . One of the tests showed that nearly all of the rats in one uro genital teast all showed a decrease in prostate volume at the conclusion of the test period.. I have been taking cyclosporine for nephrotic syndrome for nearly a year. He would not state  with any certainty that cyclosporine was the cause of my volume decrease but he suspects that it is. Ron.