PROSTATE CANCER AND CHRONIC KIDNEY DISEASE ?

[renegade70]

I was diagnosed with low-level prostate cancer 3 years ago. 12-core biopsy showed 1 core of 3+3=6 adenocarcinoma, 30%. I along with my urologist decided on AS. I have had regular psa testing ( psa fluctuates between 5-10. I had 2 mri during this period which basically showed nothing rads 2.

I recently had a second 12-core biopsy which showed 4 cores of 3+3=6 and 1 core 3+4=7, under 10 %. My urologist has now referred me to a radiation oncologist for a consult appt. tomorrow.

Since I also have ckd stage 3 , I am very concerned with preserving kidney function. my question to anyone who may be in a similar position is whether or not any form of radiation is the way to go in this situation. It seems to me that radiation may well harm the kidneys? I have also spoken to my nephrologist; she says she has had patients in similar situations, and radiation had not been an issue. I have read information that is not so reassuring.

i am a 72 year old and I am very reluctant to undergo surgical removal of the prostate.

I will also be going for a second opinion next week at a larger hospital with a very good reputation: Massachusetts General Hospital, Boston, MA. It is one of the better hospitals in the US.

However, i would be like to know from anyone who may has been in this situation what their experience may have been?

[Tall_Allen]

Why would radiation to your prostate harm your kidneys? Modern radiation can have sub-millimeter accuracy and conforms to the shape of your prostate.

[renegade70 in reply to Tall_Allen]

it is just the thought of having radiation in your body. i know that som men have side effects such as fatigue, lack of appetite, nausea. if it affects some men with those side effects , who is to say it could not affect the kidneys ?

[Tall_Allen in reply to renegade70]

The fatigue is caused by more treatments - there is less fatigue with fewer treatments. It is probably due to the release of inflammatory cytokines:

prostatecancer.news/2017/11...

The actual kidney dose is minuscule.

[renegade70 in reply to Tall_Allen]

very interesting. thank you.

[eswann3937 in reply to Tall_Allen]

Radiation of the prostate should not affect your kidney function. With your most recent biopsy result and history of treatment You should probably consider cryoanlation of the prostate. I had it done as a primary procedure but you may have it after radiation as well.

Good luck!

[Tall_Allen in reply to eswann3937]

Whole gland Cryoablation carries high risk of incontinence.

[renegade70 in reply to eswann3937]

thanks so much.

[Nordman]

I have only one kidney and stage 3b CKD, so like you I am very keen to maintain good kidney function.

I received RT for a similar PCa diagnosis and I found focused RT was not harmful to my kidney.

However, with CKD and PCa there are other related interventions you should be very careful about.

What can be potentially and significantly harmful is Gadolinium contrast which is generally given to enhance an MRI of the prostate. I decline this contrast.

Iodine contrast can also be potentially nephrotoxic. I receive this along with an annual CT scan, which always concerns me pre scan.

If you are diabetic (I am not) then these contrasts can be even more of a risk for those with CKD.

With CKD a majority of antibiotics can also be potentially harmful. Some more than others. You have to be aware of their individual risk profile.

[renegade70 in reply to Nordman]

thany you for your kind advice.

[USAFproudmom]

my husband is 61, Gleason 4+3=7. Was diagnosed at age 59 and also has stage 3 CKD. He opted for radiation treatment as well and had no issues. He did 45 treatments and took Orgovyx for 6 months. His Nephrologist monitored and said there were no issues with his kidney (he only has one since 2004).

[renegade70 in reply to USAFproudmom]

thanks for your advice. much appreciated.

[MurphyBlack]

Have a look @ the ProtecT Trial done in Great Britain showing similar mortality rates in 10 years of radiation, prostate removal, and Acitve Surveillance for those with similar numbers to you. Take your time, get 2nd opinion on biopsies as well. Decide whether you wish quality of life or quantity of life. You may find Active Surveillance for a while at least may provide you the quality of life longer just as you are with no side effects.

[renegade70 in reply to MurphyBlack]

i have been on AS for close to 3 years. i will look at this trial in britain. thank you.

[SsgCulldelight]

Hi Sturgis removal congress with a host of other physical and medical challenges at your age sir. Once the urethra as severed and tree attached your urinary function will define because the pelvic floor becomes weak, that is the muscles that control contracting to push out urine, also there will be a boost of meds they Will put you on. Not trying to scare or discourage you, in just saying from experience and historic data that these are challenges that you will likely face. And Know that radiation and or chemo has very low success rates vs the side effects. Do your research and compare with second opinion. Cheers hire that helps.

[Sandy752]

I lost one kidney to kidney cancer in 1989 when I was 44. Twenty-one years later at 65 I was diagnosed with prostate cancer. I had 42 treatments of radiation. It did not cure me but my cancer has remained in check during 14 years on Lupron. Radiation had no effect on the function of my one remaining kidney.

[renegade70 in reply to Sandy752]

thanks very much for your input.