Radiation therapy or Turp first?

[3putt]

Guys, I posted last week on this issue but looking for additional feedback. Appears my cancer is spreading after 5 years but also experiencing urination issues at same time. I met with urologist and he suggests Turp procedure. I meet with radiation oncologist next week.

My question is has anyone experienced urination relief as a by product of the radiation therapy?

if you haven’t guessed, I’m a chicken regardless of either procedure but wondering which one makes the most sense to do first?

As always, your comments are most appreciated.

[Tall_Allen]

TURP has to precede prostate radiation by at least 6 months. Otherwise, there is significant risk of incontinence.

[3putt in reply to Tall_Allen]

Much appreciated sir

[hopefull99]

I had tried FloMax about a year ago and saw no effects.

I am currently doing my 30th radiation session of 39 scheduled. I had severe problems urinating a couple of weeks ago ... tried FloMax again and it worked very effectively in allowing me to urinate easily. Yesterday I increased the dose to 2 pill and had to get up only twice at night.

I understand that radiation will shrink the size of the prostate. In addition mine had shrunk to almost half from the first time I tried Flomax (due to hormone therapy).

So TURP before radiaton would be useful, or you may be able to avoid it by doing radiation first and trying FloMax.

[3putt]

Thanks so much for your reply. How were your side effects early on in your radiation journey?

[3putt]

Also, were you having any urination issues prior to starting radiation? Thanks again for sharing.

[Biru49]

I haven't had any experience with this issue.

[BanjoPicker]

My Experience: Urologist and RO conferred and suggested that I address my PCa first and see how my urological problems fared. After 43 IMRT hits, I went from 2/day Flomax to 1/day. But, my stream was still extremely slow. Two urologists said that I had a medial lobe that was pushing into the bladder restricting flow to a near dribble. Main urologist said that his opinion was to find a surgeon that was comfortable working on an irradiated prostate. He smiled and said he would be that surgeon. I had a TURP one week ago. I’m to expect some blood in my urine for the next month. Urgency is back but is expected to calm down with time. TURP is not a “walk in the park”. But, I’m peeing like a fire hose. Urologist would not perform TURP until one year post radiation. I’ve selected this path with the prime consideration being QOL.

[3putt in reply to BanjoPicker]

Thank you. I’m on that same page. QOL is my main goal.

[3putt in reply to BanjoPicker]

Also, would you care elaborate a bit on your radiation journey?

[BanjoPicker]

Radiation: My first reaction to treatment was RP. I told my wife it would fix my urinary issues and address the cancer. My urologist insisted that at my age (74) he highly recommended that I consult a RO and wrote a referral to the RO and arranged the appointment for the next week. The RO said that my IPSS was concerning and that radiation could trigger a retention event. Because of that possibility, the RO favored the 43 Hits of IMRT. The higher dose radiation course causes more swelling in the targeted area. The RO insisted on SpaceOAR so he referred me to a second urologist for gel placement. I “enjoyed” the visits to the tech team that did the treatments. I struggled early with urgency because I was overfilling my bladder. The treatments were quick and painless. At about dose 39 I was down to a little dribble when I peed. But a week post treatment my stream was back to its pre-treatment slow void. I had more side effects from the 4-month Eligard shot I got before radiation. ADT was specifically to shrink my enlarged prostate. I chose radiation because it offered a better QOL probability. If you want to discuss in more detail PM me your phone number and I’ll give you a call. —John

[3putt in reply to BanjoPicker]

I really appreciate your generous offer as well as sharing your experience. Please allow me to take a rain check on reaching out till after my appointment on Monday with radiation oncologist. Thanks