PSMA and bladder Cancer?

[spencoid2]

I have been having various difficulties with urination and know that my bladder is messed up. I have radiation cystitis and who knows what else. I saw my urologist recently and he had little to offer, sort of said yes you are a mess and pretty much left it at that.

I have had PSMA pet scans and SPECT scans and nothing unusual shows up in my bladder. But how could it with all the background uptake in the bladder.

Could I have prostate cancer in my bladder but no one notices because it is masked in the scans that I have had. I had a lot of radiation 10 years ago to that area and one of the suggested side effects was the possibility of other cancers.

I am getting really tired of the pain (varies from not a big deal to a big deal) and the bleeding etc. Should I have another scan like an MRI or some other sort of scan specifically to visualize my bladder? I have very a very small bladder capacity and previous scans do remark on how thcik my bladder wall is.

Recent scans show "calcification near the bladder neck" could this be something else? Why would calcification cause bleeding?

[hz5flm]

Wow, your symptoms are similar to my husband. Pain always during urination, TURP procedure was done and found a lot of dead cancer cells between prostate and bladder opening. Removed all of the nasty stuff along with " calcified dead cancer cells around live ones! Figured that the Pluvicto could not penetrate through.Now, left with intermittent bleeding and these pain attacks. Does this help at all?

[spencoid2 in reply to hz5flm]

I had both brachytherapy and IMRT about 11 years ago to "cure" prostate cancer which of course it did not, had already metastasized, so the whole area is scar tissue. Had an emergency TURP which made things worse. Have not healed completely after that so I do not want any more crude grinding away. Maybe careful surgery looking at the quality of the tissue and its ability to heal or whatever they can do but not brutal roto rooting for me.

I asked my urologist if it made sense to do a cystoscopy and he did not think so but I sort of disagree. I had an old cystoscope set that I bought for looking into engines before they had the cool fiber stuff. Fortunately I threw it away so I am not tempted to stick stuff into my pee pee, but wait a minute? I have all sorts of little fiber bore scopes. I wonder if it is worth a look

[Mcrpca in reply to spencoid2]

I hope that’s an April Fool’s joke.

[spencoid2 in reply to Mcrpca]

i think i will leave cystoscopy to a pro. i would not even know what to look for. my colonoscopy looked like a bunch of pink stuff. i imagine the pee tube and bladder would look the same to the untrained eye.

[Mcrpca in reply to spencoid2]

Good plan.

[Tommyj2 in reply to spencoid2]

Now THERES a bright idea…..sticking the wrong tool up your penis to search for…..WHAT? I’d seriously NOT give in to the urge!

[Spyder54 in reply to spencoid2]

I had 4 Cystoscopes at 4 institutions. Very uncomfortable for me. I asked for light general anesthesia last 2. Only way I would do now. They were able to see where bleeding was coming from in 1st and cauterize the bleeding. No further issues.

[FlyJ]

Perhaps a simple in the office cystoscopy might answer these questions. You could get urine cytology first.

[Ron53 in reply to FlyJ]

I agree, had to have two (cystoscopy). The cancer was "scrapped off" the bladder neck with follow on radiation and no issues since...at least in that area. BTW...I was peeing chunks of blood. Thought I was done for.

[spencoid2 in reply to Ron53]

same here the chunks of coagulated blood and tissue are scary but no one seems to think it is a big deal. i understand that after the emergency TURP but not now.

[spencoid2 in reply to FlyJ]

I have had many urine analysis but no one suggested cytology. If I knew what a cancer cell looks like I could do it myself. I have all the tools to do a urine sediment test, the centrifuge, counting slides the right stain and a phase contrast microscope. Hmmmm. I will have a look because right now there is a lot of blood and I am sure it will be a real mess. But I should ask for professional cytology. I wonder if my urologist can just order it done at the local lab.

[Spyder54 in reply to spencoid2]

Spencoid2,

If it clots closed, you will not be able to pass urine, and will end up in ER.

I hate that I am saying this, but I would demand treatment and get whatever is bleeding cauterized, and clean up the area.

My 2nd TURP was not to invade the prostate. It was to cauterize the area of the bladder that was bleeding. I had lifted some heavy chairs and caused a bladder tear.

Best of luck, Mike

[spencoid2 in reply to Spyder54]

i have been dealing with intermittent bleeding and clots for years. i always manage to get a catheter in. i am just a little more concerned as the pain is a bit more and the frequency too. thinking it should be looked at although no one else seems to think so.

[Ron53]

I would think it must be performed by a Urologist...they ago up thru your unrinary track with scope or something. They put me to sleep of course for the removal o the cancer.

[spencoid2 in reply to Ron53]

i think you must have had a biopsy which is better and must be performed by a doctor but cytology needs just a urine sample. i messaged my urologist to see if he can order it. online it says that cytology can not detect all cancers so maybe only if it is shedding cells but something is certainly shedding something. i am going to do a sediment test myself but it seems that it should be done with first urine of the AM. wonder what that is since i get up to pee every couple of hours.

[maley2711 in reply to spencoid2]

I've been living with peeing every 2-3 hours for many years....is that disastrous for you? or the other problems?

[spencoid2 in reply to maley2711]

it is not the frequent peeing. the pain and the blood which suggests something more might be going on. i was thinking it might be another type of cancer caused by the radiation 10 or more years ago. the time is just about right.

i have an appointment with another radiation oncologist soon and will ask her various questions.

[maley2711 in reply to spencoid2]

Wishing you well !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[Tonyliv]

I have had radiotherapy in the region and my prostate cancer has spread to my bladder. It is a poorly defined adenocarcenoma that is aggressive. Discovered 9 months ago when a biopsy was taken during a bladder neck incision operation to improve flow. Can’t be cut out as spread to blood vessels around. Possibly scrapings can be done. I would recommend a cystoscopy to clarify what’s going on.

[Mgtd]

Glad I had breakfast before reading this.

As I was reading it something came to mind. Seems like two things popped out. One 10 years and older style radiation.

Maybe a discussion with a RO rather than a urologist might help. Just thinking.

[anonymoose2]

My MO (who has been fired in the past) told me you can’t get PC in the bladder. Take it for what’s it’s worth. As I really don’t know.

Something I will ask my new MO one of these days.

[Rocketman1960]

Bladder issues are the worst. I assume you have tried AZO on an ongoing basis to relieve pain, spasms and the like? It has given me some relief as it has antiseptic and analgesic properties. It is OTC and the generics are cheap and work just as well.

[hz5flm in reply to Rocketman1960]

What is AZO?

[Rocketman1960 in reply to hz5flm]

It is a urinary tract med that is Over the Counter. Go to any pharmacy and ask them for it.

[spencoid2 in reply to Rocketman1960]

really difficult to tell what it is supposed to do from the web site and there is no mention of pan control spasms etc. it seems to be just to reduce the chance of UTIs and fungal infections.

i take methenamine hippurat which is prescription and greatly reduces the number of UTIs that i get. it is a prophylactic not an antibiotic. it is take together with vitamin C to acidify the urine.

it does not fix other problems directly nor does AZO but if you have a UTI you will have pain etc so not having UTIs is really important.

[SpencerBoy11]

I had PCa in my bladder. It was only discovered by running a camera into my bladder. Uncomfortable to say the least. The UR had just said that I had a pretty good bladder for an 80 old, when we both saw the evil floating by.

[j-o-h-n]

For God's sake........ see a new GOOD urologist and have him/her perform an in-office cystography of your bladder (I've had several performed, all like a breeze).....When I asked the doctor(s) what does Ca look like, a couple of different docs said "it looks like cauliflower"....

Good Luck, Good Health and Good Humor.

j-o-h-n

[TJGuy in reply to j-o-h-n]

My surgeon told me PC looks like Cheerios. I don't know be he started RP operations very early in the morning, maybe breakfast was still on his mind. LoL

[j-o-h-n]

LOL - Fruit loops?

Good Luck, Good Health and Good Humor.

j-o-h-n

[hz5flm]

My husband has had the TURP Procedure done in Feb. Urologist said it was narly in there! Prostate pushing into bladder wall. Dead calcified cancer cells encased live ones! 50 samples taken, 45 positive for cancer still. And this is while being on the Pluvicto injections. Its always a state of unanswered questions regarding the pain attacks.