Hi all,
Just got news for my dad that his Kidney is only 60% functioning.. super nervous and anxious to really research online what this means.. is this common after treatment.. is this a really bad sign.. I am super frantic right now and have no idea if this is releated to the prostate cancer, or the ADT treatment or the radiation?
No chemo given.. PSA undectable after radiation so was happy but this seems to be a new scare
Probably unrelated, unless urine is not flowing out because cancer is blocking it.
So a whole new problem.. Trying to find out if it is just one kidney or both. I found out second hand through my mom and all she knows is that he told her 60%. Under 60% is when there is worry but being on the line is not comforting at all either.
Since completing radiation treatment he has been urinating much better. Although as of late he has been going more frequently which to me means he is retaining more fluid once again. it has been six months since he has FINISHED radiation so I don't believe this is a radiation symptom.
That being said his PSA as of 1.5 weeks ago was sitting at <0.1. You would think this means no further cancer progression. But the symptom of urinating more seems like a bad thing. My head is a mess, his prostate was 88% cancer originally (gleason score 9). Good or bad based on this information do you think the odds are that cancer has NOT progressed ? or am I putting too much weight to that <0.1 PSA number?
As I said, there is probably no relation, unless the cancer has damaged the kidneys.
Or the ureters were damaged during radiation??
This is one thing I did read … technically this is his first kidney test since September 2022. This kidney test was by a blood test . I read that 1 of 2 things.. radiation damage although it could recover on its own
Or cancer spread to ureters. But I want to think that the <0.1 PSA reading means that cancer has not progressed or spread since the start of treatment. Do you know if that PSA reading is usually a good indicator of that or is it completely unrelated ?
He has another bone scan and CT scan scheduled for the end of this month so we’ll find out for sure I guess early to mid September by the time the results roll in
Also that is assuming they can do those tests as I am reading online that CT scans require good kidney function. so this kidney function may need to be resolved first
Ureters are not irradiated by prostate radiation.
They fall within / cross the common iliac lymph node margins.
If all lymph nodes radiated.
They should not be leaving margins outside of the lymph node area.
I’m reading that ADT does Increase the probability of acute kidney injury for newly diagnosed patients with non metastatic prostate cancer
What worries me right now is that’s true it says the it recovers once off of ADT.. we’ll he has another 2-3 years of ADT so now what .. he can’t afford to get off of ADT and on the other hand kidney failure will kill anyone
You are misinterpreting whatever you are reading. His kidney injury is unrelated to his prostate cancer treatment. It is possible that the cancer has caused urine to back up to the kidneys.
I am not misreading the study but you could still be right about it not being related. This study has just over 10k participants and it goes on to say that prostate cancer patients on ADT are 2.5 times more likely to develop acute kidney injury (although other factors like alcohol and tabacco could have some further play in that)
appreciate the time and responses .. we’ll have to see what the doctors tell him next . Hoping it’s something that can recover and not be a major issue
latimes.com/science/la-xpm-...
Association is not causation. Men with PCa on ADT are also more likely to have a serious form of PCa that has invaded the kidneys.
232 out of 10250, around 2.2%. If you look at the mean ages, comorbidities, laundry list of pharmaceuticals they're taking, and lifestyle choices, probably better than average. The study needs much more detail.
The ureters cross into the lymph node area.
I saw it on my contouring!
"The most common radiation-induced complications include haemorrhagic cystitis, urethral and ureteral strictures, urinary fistulae, and secondary primary malignancies."
\ncbi.nlm.nih.gov/pmc/articl....
That's why God invented contouring. Ureters extend from inside the kidneys to inside the bladder and are not irradiated. Your link is about pelvic radiotherapy- not about this.
I do not have the knowledge or experience on kidney function, other than that due to low urine outflow my dad has to use foley catether for 3 years now. His kidney function remains normal.
And I’m sorry to see you suffering. As with every serious disease, there are two groups of victims - the patient and his loved ones.
I hope you will get answers soon and that news will be good, so you could find some relief as well.
What was his kidney function prior to doing CT scans.
Creatinine and EGFR test are usually done prior to a CT with dye.
His kidney function was normal/above average for his age group prior to his first and second CT scan which was back last year prior to radiation (September 2022).
This is what has me worried how it could drop like this. I am researching like crazy but there doesn’t seem to be much information so I have no clue what to think.
I feel like it must be related to something about the treatment .. he does drink a lot but has his whole life (hasn’t stopped not even during treatment) BUT his kindey function last year was normal/ slight above average for his age group
I have often wondered about this. Over the years I've asked all my medics. All say treatment should not affect the kidneys, but my records show my eFGR was 58-61 for 8 years prior to any treatment, then a drop to 44 , two weeks after starting cyproterone Jan 2014, then a slow drop to 37 over the next 3 years whilst on Lucrin. Radiation did not seem to effect eFGR. I cannot recall when I had my CTs. Recommenced Lucrin in June 2022 but it did not affect the kidney readings. A bout of gout in March/23 knocked eFGR down to 28 but has since come back to 33. I'm also Gl 9 current PSA <0.3. Coming up for my 10 year anniversary in 4 months (from dx) so not particularly worried. At his eGFR and PSA I would be ecstatic.
When I was on adt I chose not to drink my daily wine 🍷 as one of the main possible side effects was liver n kidney damage just from the drugs. As soon as I opted to go the ivermectin route as opposed to the harmful hormone deprivation drugs that also include possible heart damage, i slowly incorporated red wine back into my regimen n watched my liver n kidney functions closely n they are all wnl where as when I was on adt they elevated a bit. My recommendation is maybe cut back or out the alcohol atleast during the time being treatment n listen to your Drs closely…
This is generally not an issue. Prior to PCA, my kidney function was 43% and the nephrologist told me that I had 50 more years left on them. I was told that they do not even measure it until it gets below 60% so there is nothing to worry about.
Look at this article kidney.org/atoz/content/gfr
60% is ok. Kidney function decreases with age.
Had the same problem with the right kidney and a non cancerous tumor pressing on the Ureter 2 biopsy done in second opinion. Stint placed in to open so the urine could drain out of kidney. Even was talk to remove the kidney until Covid hit. In that time everything healed and kidney function returned. Thank you Covid pandemic.
All the doctors said stop worrying you can get by with one kidney. Hard to take in when it hurts.
I had increase in PSA when immunotherapy failed last winter, from 35 in November to 260 by May. Cancer clearly was active and spreading. Sonogram of kidneys was ordered by PCP. Left kidney showed inflammation due to hydronephrosis(kidney not draining through ureter. I would ask for doppler ultrasound of kidneys as first step toward diagnosis.). Had bilateral nephrostomy(tubes installed through back into each kidney to positively drain externally) in mid June. Kidney function is nothing to fool around with. Oncologist reviewed PSMA scan and said blockage of ureters was due to enlarged cancerous lymph nodes pressing on ureters. Though lack of tubes protruding from one's back would be preferable, this was probably the best solution, even better than internal stents in that I also have some blockage of urethera that has yet to be addressed.
eGfr reached low point of 27(it was 114 last fall and if it fell to 16, generally dialysis would be necessary), has since recovered to 80 and is slowly increasing. In early July had Actinium 233 treatment and simultaneous beginning of Orgovyx. PSA at end of July was 7. Tomorrow receive first of 2 scheduled LU-177 treatments. Oncologist hopes that by the end of September nephrostomy tubes may no longer be required. An additional surprise this summer was a DVT caused by swollen lymph nodes occluding right femoral vein at Iliac crest. Some pain, inability to walk, swelling of entire leg and treatment with inari clotreiver to remove 2' long blood clot. Both legs treated and stents installed at Iliac crest. What a summer! Whatever the cause for loss of kidney function- insist Drs. go after a definite diagnosis and institute an appropriate follow up treatment.
I get 15% of urine from my left kidney and 85 % from my right one. (no problem)...
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 08/15/2023 1:29 PM DST
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