Update

[Nicholas27]

Grandad went in for his PMSA pet scan, results show growth um the seminal vesicles and bottom of the bladder, there were also a few spots on close by lymph nodes. No spread to liver, kidneys, lungs or bones (thank goodness).

Was prescribed bicalutamide which he immediately started and is going in for a shot (not to sure which one) In a weeks time.

As he currently has urinary difficulties he has the option to operate and open up the urethra to help him urinate which however, would mean he would have to postpone the radiation by 3 months until it heals.

Obviously aggressive therapy is warranted and it’s definitely the option depending on this first operation. Any thoughts or suggestions would be a big help. I think the way to go is radiation plus systemic therapy. My only concern is waiting another 3 months until then if he decides to open up his Urine passage.

Thanks

[Tall_Allen]

The injection he is getting will put a halt to any further cancer growth for up to several years. In these times, he may want to ask for a 6-month shot, so he can avoid hospitals for a while.

Waiting isn't a problem, but a TURP may give him other problems even if he waits. Radiation after a TURP increases the risk of incontinence. But if he is already having urinary problems, radiation will exacerbate those problems for a while until the inflamed tissues shrink. Because his bladder neck is involved, there is a risk of bladder neck contracture, which might result him him having to use a catheter for a while.

I would usually recommend that someone with his high-risk characteristics discuss brachy boost therapy, but that is out of the question for him. Is there any reason why he can't have a radical prostatectomy, followed soon after by whole pelvic radiation (with boosts to the bladder neck and known involved lymph nodes)?

[Nicholas27 in reply to Tall_Allen]

From the recording I heard the doctor said the prostate cancer has gone to the bottom of the bladder and is real close to where the ureter attaches to the bladder, so removing that tissue might impact the piping causing worse urinary issues

[Tall_Allen in reply to Nicholas27]

You can remove the prostate up to the bladder neck and use radiation to get the cancer that has infiltrated the bladder.

[Nicholas27 in reply to Tall_Allen]

I’ll suggest this to him as an option, and discuss it with the oncologist next week during his appointment

[Hidden]

Hey Nicholas27. I welcome you as an advocate for your Granddad . Very good of you to do so . The adt shot will

Hopefully bring his PSA and pc down too. Good job finding us. Ask and you shall receive many answers .. from those in the know. T _A offers sound advice .. Good looking out for your grandpa. !😎

[j-o-h-n]

Urinary stents?

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 05/08/2020 5:51 PM DST