Advanced Prostate Cancer
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Green light laser?

Im newly diagnosed with stage 4, extensive spine mets. PSA at diagnosis was 11. Now on lupron, docetal chemo, and zymeta. After 1 month, PSA down to 4.5. Good direction. However, just after my diagnosis i had RFA ablation on a large spine met and they put in a catheter. The days leading up to the surgery, i had been having trouble urinating and with the cath they pulled out 1000 cc - so lots of retention. Originally med onc said to leave the cath in while the chemo and lupron shrink my prostate back down. But i went this week to get it taken out, and with a fill and pull, i was still retaining way too much. Now the urologist wants to schedule a green light laser to open me up. Obviously im not eager and just want the chemo to shrink me. Anyone else get a greenlight during/after chemo? Most posts ive seen about surgery are about removal of the entire prostate. Since my cancer is already spread, a full removal is not the plan.

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I underwent chemo and proton beam therapy to my prostate. Unfortunately I got radiation cystitis (which responded excellently to several weeks of hyperbaric oxygen therapy). I had about 300 ml urinary residual and on cystoscopy my urologist found 2 little bars of prostate tissue partially obstructing my bladder outlet. He felt a very minor operation with green light laser could do the job.

I spoke with Dr Mark Scholtz ,a prostate oncologist many of you have heard of on this forum.

He was very unenthusiastic about the idea,felt healing could be problematic.

Your retention is much worse than mine but then again your prostate hasn't been radiated like mine--what would be lost by waiting to see what lupron does and after you have recuperated from your chemo?

Just my 2 cents worth,keep the change and good luck

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Hi sorry im late, bro, it seems as though your issues are a bit more complex than mine were, if they cut ya Knife or laser what is the benefit?? long term short term or none, if you think its going to make you feel better and relieve you of urination issues then hell go for it, if the catheter works for you then you know what to do, remove the prostate if necessary, but if that is not going to improve your situation you know what to do. Like I said that ish is complex in your situation. Much love and support, stay up bro itll get better but one thing for sure, YOU have GOT TO BELIEVE that you beat it.

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Sounds like you need 'roto rooter' type surgery, usually done for bph type enlargement of prostate. I got the standard TURP procedure years ago. Laser was the alternative but the surgeon felt more comfortable and experienced with TURP. You may want to google 'rezum'; it is supposed to be a less invasive procedure used to open up the channel. Not sure if it applies to your condition or not and you may have to search for a provider for this; it is new.

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An update. Yesterday went in to urologist and took out cath. I am now able to pee mostly normally - was up only 2x last night. Im definately retaining some, but all docs are happy for now. Such a relief to avoid surgery while on chemo. And such a relief since i kept getting infections. Now will have chemo 3 monday. Hopefully just better from there.

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Yah! Cath out and rid of infections.Thats a great move in the right direction. I have not done chemo..I dont envy you there. Don't know if you like reggae or not .If so ,check out jimmy cliffs " many rivers to cross" until I find my way over.Stumbleling i am lost.... these words to me typify our path to deal with APC .We fight on so many different levels. Many rivers to ford.In order to cross this river and make it to some better quality of life we choose these medical treatments that do much damage but hopefully more good then bad. It is our job to take more care of our selves and attempt to counter act the treatments.. There is nothing easy or even easily explainable about treatments. There is suffering.. The only other option is death.we choose life , so don't give up. You will do what you have to, but do more ... enjoy music ,art ,nature and whatever things that you have especially enjoyed before in your life. hold on to hope of better health and recovery.If a mind is free of far and torment you can focus more on good healing hormones ..Important to sleep well..20 mg melatonine plus 2.5 mg of naltrexone before bed help and both are said to fight "C"..Good luck and thanks for staying in touch.

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Your post was a while ago but sounds like green light laser might come up again. Your starting condition is very similar to my husbands (3-1/2 years ago). He had very bad hip pain, and a visit to the orthopedist revealed prostate cancer -- already advanced into the bones (pelvis, which had a hairline fracture) but also up into the spine - L3/L4, minimal LN. PSA was low too (around 40 I think) but Gleason 9 (probably really a 10 as everything was cancer.

He did early chemo (CHAARTED study had just been released) started on Lupron, Zometa (1x) then switched to Xgeva, Casodex. He went castration resistant in about a year or so. Did Provenge. Got a "spot weld" of radiation in the spine (just 5 zaps), RA223/Xofigo (seemed to help decrease diffuse little bone mets but he only tolerated 4 doses). At about 2 years, he stabilized. mCRPC went to Xtandi, which he is still on (almost 2 years) -- but clinically (blood and scans) starting to fail, slowly.

About 16 months ago, he was having trouble urinating -- flow wouldn't stop, felt like he had to go but didn't have much, then sometimes real urgency. He had a green light laser procedure to clear the prostate out of the tubing. This gave him great relief. It is a typical BPH procedure but it works for this kind of blockage too. Other than the catheter over the weekend for healing (which was plenty enough for him!!) -- and the visual imagery of the procedure in his mind -- the procedure/aftermath was not a big deal. And he was so happy he did it. He's still OK on that front. (December 2016.) But -- here's hoping you last a good long while on Casodex and/or Lupron and don't have to deal with the laser any time soon.

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Thank you for sharing your experience!

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Those of us that have gone through or witnessed these urological problems caused by APC wish them upon no one else......Even on our darkest days ,if we have love,it helps everything to be more bearable.

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