Can Lupron trigger gross hematuria with clots in those men with radiation cystitis? Anyone experience this?

[Teddy28]

I have experienced 3 bouts of Hematuria with clots this year that sent me to the hospital ER because of blockage. After the first, I was advised I had radiation cystitis, which was 6 years out from salvage radiation. This year I started on Lupron and Xtandi for prostate cancer recurrence and had three 3 month duration Lupron shots, and two one month duration shots. Some observations:

• Hematuria occurred about 1 week following the monthly duration Lupron for both Oct and Nov

• Hematuria occurred about 23 days after my April (3 month) Lupron injection

• The prescribing information for Lupron notes that in the case of the 6 month injection, 6.6% of patients experienced Hematuria or Hemorrhagic Cystitis as a ‘treatment emergent” adverse event, although none experienced this as a ‘treatment related’ event. Maybe Lupron aggravates an underlying condition (eg radiation cystitis in my case).

• The prescribing information also notes that for the 3 month, 4 month, and 6 month duration Lupron injections, Lupron reaches its steady state concentration during the 3rd week after dosing, during the 4th week after dosing, and during the 3rd week after dosing, respectively. This lines up with my May hematuria event following April Lupron injection.

• My thinking is that Lupron increases vulnerability to blood vessel rupture / Hematuria for those patients with underlying conditions (radiation cystitis). It just cannot be coincidence.

• I am trying to make a judgement as to whether the risk of another hematuria event is reduced in the absence of Lupron. Is there some ‘reversibility’ of the this condition?

• Anybody see a similar pattern?

My MO does not see Lupron as a contributing factor however my urologist says otherwise.

[Tall_Allen]

Have you discussed hyperbaric oxygen therapy?

[Lyubov in reply to Tall_Allen]

My husband's MO cautioned against hyperbaric treatment, indicating it actually increases PCa cell growth. . .

[Tall_Allen in reply to Lyubov]

There are possible side effects. Those have to be weighed against the potential benefits.

[Teddy28 in reply to Lyubov]

Lyubov, that's quite interesting . My MO had no concerns. Perhaps because I was being treated with xtandi and lupron at the time. I asked about this because I have a lung nodule which is prostate cancer and would be very exposed to the hyperbaric oxygen.

[Lyubov in reply to Teddy28]

Yes, my husband's PSA had been low but rising, suggesting PCa presence? But he's in somewhat debilated condition, so MO waiting for rise to much higher (it's been holding at 0.61) before trying ADT. But HBOT he didn't think was prudent at this time.

[Teddy28 in reply to Tall_Allen]

Tall_Allen - I had 20 sessions of HBOT in August. the October hematuria event was the same I had Botox for overactive bladder, so a bad combination of events. No one has been able to advise how long it takes for HBOT therapy to work but I will no longer do Botox and I am off Lupron, so if I get another hematuria event, I will do more HBOT.

[bluepacifica]

My husband, too, also ended up in the ER with blockage. Now when he sees blood, he takes Bactrim right away and that stops it. He bleeds with a bladder infection.

[old64horn]

I developed hematuria 9 months after IMRT to the prostate bed in lymph nodes. My Urologist cauterized the bladder which stopped the bleeding but it created urgency, frequency and incontinence right after the catheter was removed.

[Munchkin2840 in reply to old64horn]

I had the same treatment after several trips to the ER for bladder blockage.My Oncologist recommended 8 weeks of HBOT and have had no more bleeding issues. It has been over 3 years now.

I definitely would recommend this treatment for anyone that is experiencing continuous bleeding from blood vessels in your bladder.

The cauterization also helped.

[Teddy28 in reply to Munchkin2840]

Munchkin - thanks for your comment. Did you have all the HBOT at one time - or did you do 4 weeks and then assess your situation and then decide to continue HBOT? My urologist recommends I go for 4 more weeks. My first 4 weeks were last August.

[old64horn in reply to Teddy28]

cauterization stopped the bleeding, I’m now dealing with urgency, frequency and incontinence. I’m not sure if HBOT will help with these issues.

[gottodealwithit]

after prostrate surgery Lupron injections every 6 months was prescribed. In less than 5 weeks after each of the 3 injections I was in Atrial Fibrillation. I had a history of A Fib which had been treated with Ablation. Prior to the first Lupron injection it had been 6 years with no AFib symptoms. Then within 5 weeks after the first in AFib, Ablation was successful as it was for the second time. However, after the third injection the cardiologist could not cancel the random electrical action in my atrial area and thus I am in permanent, persistent AFib. Despite this personal experience the oncologist would not accept that Lupron was the stimulus for AFib recurring. However, I did not take the planned fourth Lupron injection and for the past 7 years my PSA has remained undetectable.