Pain in the hip and knee, Low PSA

[Back2future]

Been on ADT (Abiraterone + Orgovyx) therapy since April 2021 and my PSA has been in a range ~ .3- .6 since then. Never had prostate removed as it had already metastesized. A few days ago started having pain in the hip and knee which is getting worse. Nothing helps alleviate the pain. I tried heat & cold packs and Tylenol. I was thinking also getting a new PSA test to see if any increase since Sept. 2. Which scan would detect any new mets? MRI with contrast? Any pain meds that would help with the pain?

[GP24]

ADT can cause joints to hurt.

[diamondrn]

I use over-the-counter Naproxen 240mg tablets; 2 of them 2 or 3 times a day for lower back and hip pain and inflammation. Works fine for me.

I normally take 2 tablets with breakfast and 2 around 10 PM. I only need to take the 3rd dose around 2 PM every once in a while.

Not advisable if you have kidney problems, and make sure not to take them on an empty stomach if you tend to have indigestion.

Naproxen is an NSAID. 240mg is over the counter. 250mg is by prescription only. 240 is close enough for me.

[Back2future in reply to diamondrn]

Thanks, I will give it a try. Did you have your TURP done? How are you doing? Was it painful?I am planning to have it done this year. Is it true the bleeding lasts 8-12 weeks? Any words of advise? I heard its best to have the foley catheter a little longer so the prostate can heal better. Did your foley get clogged with blood clots?

[diamondrn in reply to Back2future]

The TURP is rescheduled for September 28, Back2future.

About the only thing that could stop it now is if I test positive for COVID the day before.

The VA is funny about that. :o(

[Back2future in reply to diamondrn]

My TURP was also postponed due to my extreme back pain days before surgery. Hope to reschedule in October or November. I will check back with you after your TURP procedure to see how you're doing. All surgeries now require a negative test if you're not vaccinated or fully vaccinated card. I am fully vaccinated.

[diamondrn in reply to Back2future]

I have been passing a few blood clots. They are small because they have to squeeze through the small holes in the bladder end of the catheter first; look kind of like mouse droppings. Back2future

[Back2future in reply to diamondrn]

Are you on ADT? The good news is your still passing. Have you ever had your catheter not work? That is my biggest fear especially after TURP.

[diamondrn in reply to Back2future]

I have been on ADT since January. PSA went to 160. It's under 10 now. Sick of the catheter but can't urinate without it. My understanding is that a TURP is successful most of the time; only a 1% chance of causing permanent incontinence, etc.

[Back2future in reply to diamondrn]

Have you been on Catheter since January? I had mine put in since then. My PSA was 8 in March but I already had mets when they did a biopsy in March. Is your pain from the mets? I plan to get an MRI to confirm pain is from mets or not.

[diamondrn in reply to Back2future]

I have been told that the lower back and hip pain that I am experiencing is likely related to the prostate cancer. Nothing more specific than that. I saw a bone scan of my pelvic area in late winter and it was lit up like a Christmas tree, Back2future.

[Back2future in reply to diamondrn]

That's because it metastisized and spread to other parts of the body. After your scan did you receive radiation or chemotherapy? I don't know if my pain is related. I will ask for a scan this week.

[diamondrn in reply to Back2future]

Still on ADT with Firmagon, Zytiga and prednisone.

In a recent conversation with the urology surgeon who was evaluating whether or not to schedule the TURP, I could tell that he was relieved when I told him that I haven't had any radiation therapy to date. He mumbled something about not having to deal with scar tissue.

The biggest thing about finally the getting the TURP for me is the quality of life improvement.

[Back2future in reply to diamondrn]

After two rounds of Firmagon I said "no more". I had painful scar tissue lumps at the sites of injection that took months to heal. My patient navigator said Orgovyx had recently been approved by FDA so I jumped on that and I don't have injections now. I too haven't had any radiation therapy to date. That is good because there are complications if TURP is done on radiated prostate. Same here the QOL is biggest reason for the TURP and the never ending UTIs.

[Tall_Allen]

It may be the cancer in your prostate that's causing the pain. If it is, a TURP or palliative prostate radiation may help. Meanwhile, ask your doctor for prescription NSAIDs coupled with marijuana may help.

[Back2future in reply to Tall_Allen]

The pain is in my hip not my prostate. Since I never had radiation how does it alleviate the pain? Does it kill the nerve endings so I don't feel the pain or the cancer cells? Also, there are 2 types of radiation one being shotgun approach and the others more focused (proton I think) which has less side effects?

[Tall_Allen in reply to Back2future]

Pain from the prostate is felt anywhere in the pelvic region. It eliminates the pain by eliminating the cancer there. Photon or proton makes no difference.

[Back2future in reply to Tall_Allen]

Doesn't make any sense. If the MRI detects a lesion in the pelvic bone how can they radiate the prostate and not the lesion?

[Tall_Allen in reply to Back2future]

If the MRI detects a lesion in the pelvic bone, it gets rid of pain to irradiate that too. You didn't say that you had an MRI-detected lesion in your pelvic bone.

[podsart]

Suggest 3T MRI (with and without contrast) spine and hips and legs as a baseline - would also rule out and spinal related issues such as spinal stenosis, spondyliothesis, etc. Also 3T might even show any metastases unless too small even for a good MRI such as 3T

[Back2future in reply to podsart]

My last MRI before ADT & Abiraterone did show mets but I didn't have a lot of pain then. I plan to get another MRI just to find out if new mets show or not.

[podsart in reply to Back2future]

Good luck!