Contraction

Happy New Year 2018!

For a couple of days now, I am experiencing something new that makes my peeing very difficult. Each time the flow starts, after a couple of seconds, a pulse /spam comes from the back, as if passing a gas, and the flow stops.
After a session of a couple of go/no go's, I would end up with 2-3 oz of urine. As the bladder - likely - does not void, I would have the urge to visit bathroom pretty often. I tried peeing standing, sitting, no difference.
I'm taking Rapaflo for flow, I tried Tylenol.

Anybody experienced something like this?

I had a bout of UTI (urinary infection) about 6 weeks ago, with painful urination, urine retention, blood in urine, bowel movement. After 14 days of CIPRO that seemed to have cleared.

In the past I had 4 biopsies (2011, 2012, 2013, 2015), the second BX found 1 G6 (5%), 1 HGPIN, 1 ASAP.

Since 2012, I also had a couple of scans, 1 C11Acetate, 2 MpMRIs, 1 3T MRI.
All this imaging did not reproduce my cancer, they all showed up BHP; my gland size is about 80cc.

They are planning a fusion biopsy (Uronav) for this year.

My PSA: 2011=4, 2012=10,....2017=12.
My age: 66.

Thank you for any input.
Wishing everybody a healthy year.

Nick.

Hi Allen,

Indeed, my doctors (at UCSF) have suggested these options (Avodart, TURP) in the past , yet I kept postponing those actions, until now.

When the time comes, I wonder whether my urinary complications would make RP only viable treatment option for me...

Thank you for your insight and help.
Nick

Hi Allen,

It makes sense.

In a couple of days I'll see my URO Doc, discussing next step(s), based on my latest endorectal MRI (PIRAD21=1) and my evolving condition.
I'm glad other options for treatment, beside surgery, will be available.

Nick

Nick69 said...
A couple of questions now, is it time for more aggressive action (maybe starting some HT), or follow with the new biopsy; I wonder whether MRI would be helpful in localizing anything with a PIRAD2=1 result. Is it time for a bone scan, last time I had one was 2012.

No - absolutely HT is NOT for you (other than Avodart), neither is a bone scan. A PIRADS of 1 means there is nothing suspicious - only insignificant, low grade PC (which mpMRIs cannot find).

Thank you Allen and Dennis,

Haven't been on the forum for a while..

Since my last post I had another PSA test, 12 days after Jan 04 PSA test (17.0). I was hoping it would go down a bit as my Nov 2017 UTI was wearing down. It did not (18.1).

Last week I also had my scheduled appointment with my Uro in the Hospital. He did not sound alarmed by my PSA numbers. Rectal and US exam came out normal (size 66cc). We had in plan a fusion bx, but my latest negative MRI (Nov 2017) does not support it. He asked for a PSA test in 3 months and planned a standard bx in 6 months (last bx in 2015). To my question what shall I (we) do if PSA keeps climbing the answer was will do a bx sooner..

For now I'm left with my PSA high number to worry about..
Best,
Nick

Hello Everyone,

I have mentioned in my post yesterday about pains in lower back/hips. I forgot to mention about pains in the joints of both arms, also present for a couple of weeks, varied intensity. Sometime would bother me just from carrying a flashlight in hand. It seems to me now that they are all related. I've seen them listed as symptoms for advanced PC.

Could anybody share experience, or opinion on these.
Thank you,
Nick

Thanks Island,

Indeed, I would like to hear if other people in the group experienced these kind of "funny" pains, as I mentioned before, lower back/hips(stings like)/thighs(upper)/arms(upper)/arms(joints for awhile)/chest-bone(sometimes). Pains not very strong but present and ominous..
(taking Rapaflo, no bother in the pelvic area, after an UTI that I had last Nov)

It seems that these could be signs of advanced PC..

Have been diagnosed in 2012 with PC (1 G6-3mm, R-Apex, 1 HGPIN, 1 ASAP). A recent review of 2016 Ga68 PSMA test reported a 6mm shape, "compatible with gland tumor focus", about same area of G6.
(other tests / bx'es during this time turned with negative results)

Meanwhile PSA, after jumping 11->17 ( Nov->Jan) is creeping up (19..).
With all this, I wonder shall I follow with another BX, or it is high time for Oncologist action..
Or any other idea...

Thank you all and wishing you well..
Nick

Hi Allen,

It was interesting, your analysis yesterday on tumors located in anterior regions.

I have been puzzled all these years by the low correlation between consistently elevated PSA and the test results (negative for the most part) . I understand from that analysis that, typically, anterior tumors put up more PSA and also create urinary problems (not severe, but present in my case). My gland size varies between 60-85cc (depending on "measuring tools").

It so happened that recently a Rad Doc took another look into my 2016 G68 PSMA PET/MRI study and gave a more detailed description, of an "6-7 mm uptake in the right anterior region, compatible with tumor focus". In light of this, I wonder if a standard biopsy, planned for next month, would render results different from previous ones.

Is there some literature addressing specifically cases of tumors in anterior region.

Any input from anybody would be appreciated.

I updated my signature/history bellow.

Nick

RE: UCLA MRI Scan locations

Hi All,

The Prostate Doc. recommended a MP-MRI to be done by UCLA Radiology.
He issued the order for me and I'm trying to schedule a scan, I think he mentioned initially Santa Monica location in the order.
It seems UCLA has 3 centers for MRI (Manhattan, Westwood, Santa Clarita), with Santa Clarita location easier for me to access (driving from North..) and more available.

Does anybody know do these 3 center perform same type of MRI scans (multi parametric).

Are the tests to be interpreted by the same Radiology specialists in UCLA, regardless of the lab?

Thank you very much,
Nick

Hi Allen,

My specialist doc that I just seen is located in LA area, but outside the UCLA. I understand that he trusts the specialists there.

My PSA is been stubbornly high, and he is trying to be a bit more aggressive.
He ordered an 4K test which came back 66%...I don't even know how to interpret such a high score.

He is also thinking of a targeted biopsy, after MRI, such as the kind that Dr Bahn does..
(As a matter of fact, I had a CDU targeted biopsy - Dr. Bahn- in 2013..).

Thanks,

Nick

I forgot to include 4K score in signature..

Talk to your urologist and you may be able to have the ConfirmDX test done for no charge as I was. They are still trying to add to their data and from what I understand are offering for free in some areas. My numbers are similar to yours and I'm off today for another blood draw and PSA check.

Nick,

I actually have no symptoms at this time other than urgency when I drink coffee or beer. I sleep the entire night without waking up 6/7 nights a week. My prostate was about 49 grams based on the MRI in November 2017. The results from the ConfirmDX test on the December 2017 samples were all negative. So as of now all I know is I have a high PSA value and a spot was seen on an MRI. My urologist says he's seen cases like mine before but they are rare.

Recently I had my latest MRI scan.

Here's a report summary:
-----------------------------------------------------------------
- size: 75g
- target: 1.1mm right posterolateral peripheral base;
- 50% distance from apex to base; 7 o'clock;
- abuts capsule; EPE suspicion: 2/5;
- T2:3/5; DWI:3/5; DCE: 3/5; Overall PIRADS: 3/5;
- NVI: 1(no); SVI: 1(no); lymph nodes: no;

- BPH with trabeculated appearance of the bladder, suggestive of bladder outlet obstruction.
-------------------------------------------------------------------

Lot of action on right side of the prostate: biopsy (2012) found lesion at Right Apex, PSMA/PET (2016) detected 7mm uptake in Right Anterior Region, latest scan points to Right Posterolateral Base; all more or less correlated..

I believe a biopsy targeting the new area of suspicion would be needed.

Some questions:
- report says "abuts to capsule, EPE suspicion 2/5"; what would be a practical probability for escape/margins?
- report says "..peripheral base" and then, later, "...50% distance apex to base"; is that half way (middle) between top and bottom (apex); I'm concerned for lesion being too close to base (bladder neck);
- how serious is trabeculated bladder condition, first time I heard about this; can it be treated or improved?
- with my latest PSA:17.5, what would be my risk category/group now?


Thank you for the feedback and any insights...

Nick