New to board here

JJ,

I do not know what you have inquired in the thread pointed out by Max above, but the urination issue due to RT (radiation treatment=radiotherapy) typically improves in one/two months past administration . Radiation causes localized inflammation at bladder's muscle wall where the nerves do their contraction job. The feeling differs by position (standing or laying down). In any case, you should  call the office of the urologist or radiologist and explain on your impossibility in using the apnea equipment properly due to the lack of sleep. They will provide you a drug's precription for the frequency, sleeping and any other isue you need a relief.

I had radiation back in 2006 but never had urination issues till recently. My doctor says that RT caused some scar tissue which effects (late side effect) are now present. I am taking Betmiga 25mg (mirabegrom) intermittently (one month on/off) and sleeping much better.

Hormonal treatment (HT, ADT) also causes urination frequency and influences our sleeping patterns. The culprit is our hypogonadism status (sort of menopause). HT is linked to many side effects which get nasty in some guys. Hotflashes and fatigue are the most common effects. Mood change and impaired vision may occur occasionally. The best way to fight it is to change our life style. Earlier dinners with less liquids consumption at evening and afternoon naps helps a lot. Changing diet and fitness program (physical exercises) also help me to counter the effects. I still do daily walks (2x 2.5Km), work my veggie garden and play golf. Knowing in advance what to expect made me to mentally accept the situation and gave me peace of mind. Here is a list of Eligard's possible effects;

https://www.drugs.com/sfx/eligard-side-effects.html

Regarding the PSA periodical tests, I would suggest you to have the next done one week before meeting the doctor (May) and every three months thereafter. I also recommend you to get a testosterone test done together with the PSA. This will help in verifying Eligard's effectiveness.

What is your age? Can you share more details on your other health problems?

I am not a medical doctor. I have listed in a past thread (2016) a series of medications and actions to counter HT side effects that I collected from experienced patients. I have also explained before how does radiation affect/kill cancer. Sorry but the unfriendly search engine of this forum doesn't permit me to locate it. Please try yourself looking for dated 2016 in here;

https://csn.cancer.org/search/node/VGama?page=42

http://csn.cancer.org/comment/1471252#comment-1471252

Best wishes for quick improvements.

VGama

JJ,

You haven't explained why you think if you'll ever make 80, but I cannot see any reason for you not hopping to get to the 90th as your mother.

Probably this event with prostate cancer, the therapy, the lack of sleep and the disregard of the doctors to your appeal is causing you low mood and depression. This is still more aggravated when we get the Eligard shot that deplete our testosterone in circulation. It affects us and we never think it happening.

Flomax is typically prescribed by radiologist after RT to avoid urination retention (a cause of RT inflammation). This could be the cause of your frequency. In your shoes I would visit the GP again to inquire on the issue or I would stop the Flomax. If the situation improves then you can request for something else and advice at your next visit to the urologist (May 9).

The field of the IMRT (radiotherapy) may have covered the localized lymph nodes together with the whole prostate gland, nerves bundle and seminal vesicles. The  PSA (down from ≃18.0 to 2.0 ng/ml) is an indication of success but a portion of this value is still under the influence of the Eligard six month shot. You may still see the PSA going down further but the true nadir is only found when your hypogonadism recuperates out from castration.

Only state-of-art image exams can be trusted when looking for metastases. Traditional MRI and CT hardly detect cancer of small sizes. Luck makes part of the success and we should hope for that. Be positive. You may hope to live to be 90 too. It is in your genes.

Best,

VG

I wonder where you live. The health system in Europe (NHS) uses a family doctor (GP) at front which is the physician in charge of commanding each one's health aspects. One just cannot avoid this guy if wants to get help from the NHS. Several patients from the UK have reported in this forum unpleasant confrontations with their GP for their unfriendly way when processing their cases. From your descriptions I would think that your GP will not give you the chance of having a state-of-art image exam. These guys can provide the referral for a PET/CT scan but need the approval from a specialist. You can try using diplomacy when requesting.
You need to complain strongly for getting something out from these people.

Regarding the urination, a retention case can be dangerous. Not voiding would damage the kidneys, placing the patient in the risk of death. You will find more pills for avoiding retention than pills for avoiding frequency. In any case, your PCa case involved a voluminous affected gland (7 positive cores out of 8) which could have been the cause of urination retention along the 13 years. That justifies your previous use of Finasteride (5-Alpha Reductase Inhibitour) which is recommended for treating hyperplasia.

The radiation therapy (IMRT Nov-Jan) should solve the problem by killing the cancer and shrinking the enlarged prostate gland. At beginning one experiences inflammation but latter it turns into a relief. These are the symptoms you report above. However, nobody can tell if RT has been 100% successful in just two months after administration. Your therapy also includes a portion of hormonal treatment with Eligard 6 month shots and such has not ended yet. One may be cured without knowing it exactly. You need to wait for checking your newer status via periodical PSA and testosterone blood tests. Meanwhile you can do other tests (via the GP) to check other situations. For instance, you should get a bone densitometry scan for checking any osteopenia/osteoperosis. Heart health and Diabettes. All typical in young 77 years olds afflicted with PCa.

If for any reason recurrence becomes apparent you may follow a salvage treatment that could include additional radiation (Jerry Brown Gov style), a simple HT protocol or a newer therapy now still on the drawing boards but available by that time.

What is the problem with your leg and foot? Can't you shoot the ball?

VG

JJ,

I wonder about the Gleason 9 case (negative scans) you refer above. In any case, it is not a surprise to me that a CT scan and bone scintigraphy scan did not detect his cancer. These image exams rarely identify metastases of small sizes. The PSA is a very good marker for prostate cancer (control) but it also is subjective as some aggressive types of PCa (Gs9 and 10) do not produce PSA serum or produce it in very small portions. The best is still to get an image exam, such as PET or mpMRI, with the latest contrast agents more affinity to prostate cancer cells, such as 68 ga PSMA or F18 choline.

Regarding your left foot, you may consider visiting a cardiologist too. The pain could be due to claudication in veins associated with calcification in the artery. Peripheral arterial disease is typical in the lower extremities and that can affect the feet. l have had such a feeling but now I am better since I changed my diet. The hormonal treatment also caused me sort of pain in my joints, like arthritis. Are you on any hormonal therapy?

Best,

VG