Hello all, I’m posting about my father’s prostate cancer. Was diagnosed in Aug 2020 with stage 4, mets to his back and lymph nodes. He is on Androgen Suppression Therapy, taking Degarelix injections once a month and daily oral medications of abiraterone & prednisone, and PSA levels have come down from 229 to 1.3. In early Nov, he started developing UTI-like symptoms and has had on/off fever, severe fatigue / insomnia / lack of appetite. Recent blood tests show acute kidney failure (he’s never had issues before diagnosis), low hemoglobin and high blood sugar. Doctors are doing various tests to get to the bottom of the issue, but haven’t yet. I was wondering whether the poor kidney function might be an allergic reaction to any of the medications he’s taking for the cancer treatment. Have any of you come across allergic reactions causing kidney function issues as a result of the cancer medications, particularly Degarelix? Many thanks for any advice. Wishing everyone a healthful 2021 -
Kidney function issues? : Hello all, I... - Advanced Prostate...
Kidney function issues?
Acute renal failure is identified with High BUN and Creatinine. Its difficult to tell accurately because the details of his case are not there. Still I will try to analyse...He is showing symptoms of urinary tract infection and on top of it..he has developed fever and fatigue PLUS urinary retention. Seems like infection has reached upwards to Kidneys..
It is called Glomerulonephritis.
A urine culture and sensitivity test should be done and he should be put on antibiotics which work for gram negative bacteria (E Coli, Proteus, Klebsiella etc)
Most likely, His kidney failure is reversible and he will recover without much damage to his kidneys, I doubt his meds have any role in kidney failure..
Agree with many points you made..Nal. Would like to add that most gram negative bacteria which cause UTI these days have become resistant to Bactrim because Bactrim has been used excessively. Culture and sensitivity test can only tell what bacteria it is and which antibiotics it is sensitive to.
Common ones are Cipro, Imipenem etc but they do have more side effects than Bactrim.
You may be right. The prescribing info for Firmagon says:
"Hypersensitivity: Anaphylaxis, urticaria and angioedema have
been reported. Discontinue FIRMAGON if a severe
hypersensitivity reaction occurs and manage as clinically
indicated "
The fatigue, low hemoglobin and high blood sugar may be adverse effects of the ADT. Make sure he takes his last prednisone pill at 5PM or earlier to avoid insomnia.
Sorry, should have mentioned his kidney function levels (clearly not thinking straight / a novice here):
As of Dec 20:
Urea 120 (vs. 35.7 in Aug)
Creatinine 3.8 (vs. 1.24 in Aug)
Hemoglobin 7.9 (vs. 11.9 in Aug)
HbA1C 7.9 (vs. 6.4 in Aug)
He is seeing the urologist again on Monday, hoping to get more clarity.
Do you mean how old? He’s 78..
Of course. Fully understand and don’t expect medical advice here. Just wondering if anyone else has had kidney issues come up after starting cancer treatment because of an allergy. Realize I’m grasping at straws... 😔
My husband had kidney issues caused by cancer invaded and blocked his ureters both sides. His creatinine was 3.98 the day he had nephrostomy. His kidney problem was classified as chronic kidney disease stage 4. His potassium level went high, and his hemoglobin was low. These were caused by the kidneys not functioning well, and all contributed to severe fatigue. He had to stay on very strict diet: daily intake of less than 2000mg sodium and less than 2000mg potassium plus plenty of protein, which I controlled at 70 g . I have to weigh everything put in his mouth. Since his potassium level was controlled at around 4.5, his energy level has improved a lot. With the kidney function at this level, probably your father should see a nephrologist.
Did he have heart or lung conditions or diabetes before starting prostate meds?
Just want to share that this happened to my dad too.
Advanced prostate cancer. G9. Mets to bones etc. Orcidectomy followed by zytiga and pred for a year and then kidney function started deteriorating. Creatinine rose from 1 to 5 in the space of a year. Persistent UTI. His kidneys are unable to retain sodium and hence he's on tolvaptan and various other meds.
preserving kidney function became more of a priority than cancer. So we stopped zytiga and pred (Since thankfully his psa is showing a declining trend)
Since Aug, he's not on any cancer meds. That worries me
Wow!🙏
Want to share what I have gone through in relation to your dad's experience. I am 75. First, my PSA has never risen so high (229) as your dad. But I had radiation therapy in 2008. PSA for me can be an indication of metastasis; over 10 is indication of need for treatment, prostate removal or radiation, and/or adt. Normal is 4. I have had mets in lymph nodes, as well as on bone, but that was years after PC diagnosis and rad therapy. My highest PSA ever was 35 last June. Seems possible that the UTI caused high PSA, but if so, the adt has probably resolved that.
The way your father's PSA came down is indication that his cancer is slowed by the adt.
To evaluate metastasis in kidney, need to do scans. Should check with doctor about which scans are appropriate for kidney. I don't know, MRI, CAT, PET, Xray, etc. some show activity in kidneys regardless because the activity tracers exit through the kidneys.
I never had kidney infection which seems likely in his case due to high creatinine level. Mine never got above 2 but came down (from 1.4 to normal 1.1) with adt. Low hemoglobin can be a symptom of kidney failure. Question is are the meds OR the mets causing kidney problems.
I take Lupron and Xtandi. I don't know about your dad's meds. As I see it they could be the problem due to the rapidity of reaction. But then also, it is possible for PC to grow into kidneys from lymph nodes in back. But that takes years, I think, unless we are looking at a super-agressive type.
I spoke with your Dad and he said talking to you is like talking to a Handball..... He gave up......
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 12/27/2020 6:06 PM EST
Difference of opinion and experience. I had many many urinary stents from the kidney(s) to my bladder and every insertion and removal was a piece of cake. NO pain (no nuttin)... (must take antibiotic when in and when out)....BTW through the willy of course...
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 12/27/2020 6:15 PM EST
hahahahahahaha you slay me........
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 12/27/2020 6:22 PM EST
That’s what Rudolph said to Santa.
A Greek and a Buddhist walk into a classy bar but couldn't get in....because they didn't have a Thai.........
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 12/27/2020 6:41 PM EST
j-o-h-n, they let them in with jumper leads fashioned as ties but said, you can come in but don't start anything...... 😁
Guessing Direct vs Alternating....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 12/27/2020 7:05 PM EST
I posted another Greek and Buddhist joke to you as a reply and the damn thing went into my spam folder....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 12/27/2020 7:16 PM EST