Hello everyone. I haven't been on here for a while, but this is for my brother (58 years old). He had his prostate removed about 5 years ago and followed up with radiation. He was generally okay (with a very slow rising psa and no adt) until about six months ago. He started having pain in his lower area from testicles up to lower abs. The pain is on and off and seems to be triggered by even moderate activity. The doctor performed all the scans in order to rule out tumours - all clear. My brother is an alcoholic and a heavy smoker. The doctor seems to think that the pain is related to the radiation and that my brother's lifestyle is causing the body not to heal properly. He has NOT offered any solutions or referred him to anyone! My brother has lost a lot of weight because of inactivity - he is very skinny now and he mentioned that his legs are losing strength. We have an appointment with the doctor in about two weeks and I wanted your thoughts, guys. What should I ask or tell the doctor? Do you suspect what the problem might be? What next steps can be taken? Any help will be GREATLY APPRECIATED. Thanks.
My brother has had major on and off p... - Advanced Prostate...
My brother has had major on and off pain (from testicles to lower abdominal) for more than six months and his doctor has no suggestion!
How dreadful it sounds. Your brother's drinking & smoking could be contributing to the weight loss. I hope his doctor get's him in a program to quit -- will be very hard, but with strong programs & specialists he'd have a chance. Has he tried AA? Very sorry for you to have to deal with such a difficult set of issues to try and help your brother. Best of luck to you!
Thanks for your thoughts. AA could be down the road, but now his frame of mind is too low to muster up the willpower I think. If he continues at this pace, he may have to stay in hospital for a while, and that could force him to be "dry". I hope that would rectify the pain issue for him.
Did he had a MRI of the lower thoracic and lumbar spine? He may have degenerative spine lesion affecting the nerves innervating the painful areas.
Maybe talk to a neurologist. Maybe he somehow got his pudendal nerve entrapped. That can sometimes happen after a prostatectomy. I don't know why it would be happening now. Also, I suppose he has been checked for a hernias- inguinal or femoral.
Thanks, Allen. I think your idea is great, a neurologist sounds like something I will definitely ask about at the appointment - thanks!
First question: what kind of doc is "the doctor" you refer to? I assume over the past five years that your brother has dealt with a PCP, a urologist, and an RO. Whichever doc "the doctor" is, it sounds like he offered a vague diagnosis and no potential solutions, yet your brother is returning to see HIM again rather than seeking out the opinions/suggestions of a different doc. So perhaps consider that.
It might make sense to work under the assumption that this pain is not NECESSARILY related to the PC or the treatments of PC. Don't get locked into the idea that it MUST be related to the RP or radiation, even though it could be. Meaning, perhaps see a doc who also will look at it from all possible angles, and refer you to the appropriate specialist.
Second question, which may not even relate to his current symptoms: what kind of attempts has your brother made to reduce his drinking and/or smoking? I understand that the primary concern right now is to address the pain. But even if the doc's idea that "lifestyle is causing the body not to heal properly" is off the mark, your brother surely knows that his lifestyle is not a positive contribution to better health. (Wanting docs to work to make us better, even as we do a number on our own bodies, is by no means a problem unique to your brother... I would say, it's probably the norm!)
The habits of excessive smoking and excessive drinking are both pro-inflammatory, and it is common for people having those two habits to ALSO have a pro-inflammatory diet. I am not suggesting this is causing his pain, but just that it can't be helping.
I know how hard it is from personal experience (my own excesses, as well as the addictions of friends and family members) to make lifestyle changes that address substance misuse/abuse. But even if we assume a doctor pinpoints the current pain problem and resolves it, the health issues of his smoking/drinking (as relates both to PC and overall well-being, physical AND spiritual) are no doubt apparent to him. So if insurance covers it, some visits to a mental health professional are probably in order.
Thanks so much for taking the time to help. Yes, my brother goes to a urologist up here in Canada. You are right that we should consider a second opinion as soon as possible! I never considered that the pain could be non-cancer-treatment related. He had the camera scope up the urethra during all the probing they were doing, and my brother noticed that since that procedure, he has had some sharp burning when he urinates (and he even peeed out blood a few times over these months). This situation may force him to take decisive action against his addictions, giving him better odds at decent health in the future, I guess. Thanks, Noah!
So I didn’t see you mention the burning while urinating and urinating blood until your last comment. When he had his last cystoscopy done by urologist did he take an antibiotic? My husbands urologist always prescribes antibiotics for before and after cystoscopy so he doesn’t get a urinary tract infection. UTI can cause burning and some blood. My husband had bladder cancer 10 years before prostate cancer. He was urinating large amounts of blood and clots. He then had an ultrasound which showed probable cancer. He was treated and cured of bladder cancer. Good luck!
I hope you've read noahware's excellent & totally on-target response. Again, best of luck in your efforts on behalf of your brother.
A very common cause of such pain pattern is inguinal hernia. “Common things are common.” General surgeon could sort that out (as could a good PCP) promptly.
thanks - I've put that on my list to ask the doc!
Hello TerryI live in The Netherlands - a retired Physiotherapist.
The prblem of your brother cann be caused by th S.I . joints in the lower back
This are joints in the pelvis backside between Ilium and Sacrum
Visit a Chiropractioner or Ostheopath
I wish him much succes
greetings Gerard
I had exactly the symptoms that you describe. It was caused by a hernia. Neither my GP or Oncologist diagnosed the cause of these symptoms. There is a simple way of seeing if that's the problem. When the pain is bad, press for a few minutes on the abdomen where it hurts the most. If the pain in the testicles goes away, the hernia is the problem. Fortunately, if the problem is a hernia, either surgery or using a hernia belt will solve the problem.
Thanks for that suggestion - I will investigate that
Buy yourself a rubber mallet so every time your brother smokes hit him on head with it, when he drinks alcohol.... each time hit him twice....After awhile he will get the message. You're a good brother.. so the more you pop him, the more he'll love you.
BTW The color of the mallet is optional.....
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 11/16/2021 7:46 PM EST
Before treatment, I had this pain on the left side of my groin, and it turned out that the prostate cancer had moved to my seminal vesicle on that side. After radiation treatment, I don't feel it anymore.
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