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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2004

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Danny - 29 Apr 2004 13:53 GMT
I am in my 30's and male. A few weeks ago I noticed that I have a hard
spot in my rectum about 4inches up it, maybe near my prostate. It is
hard and feels like it is under the skin and does not move. Myabe the
siize of a dime or a little smaller.

(I found this through self examination with a lubricated finger.)

It is a couple of inches aboce an internal hemroid I have.

I dont know what I should do. It is not painful. Around October last
year I had a full colonoscopy for something unrelated and they found
nothing wrong.

Is there a chance they missed something?

How would you tell if this is a prostate thing? I guess this is the
other thing that worries me. Since December I have been on
Testosterone gel from the doctor for low normal testosterone. I know
it can cause prostate problems.

Any advice?
olfart - 29 Apr 2004 14:16 GMT
> I am in my 30's and male. A few weeks ago I noticed that I have a hard
> spot in my rectum about 4inches up it, maybe near my prostate. It is
[quoted text clipped - 17 lines]
>
> Any advice?

See your Doctor
Steve Kramer - 02 May 2004 01:52 GMT
Ha!  Good advice.

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA  .1  .1  .1  .3  .4  .8
EBRT 05-07/2002 @ 47
PSA  .3 .2  .2  .2 .3
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA  .1, .1
Lupron 7/03, 8/03, 12/03, 4/04

> > I am in my 30's and male. A few weeks ago I noticed that I have a hard
> > spot in my rectum about 4inches up it, maybe near my prostate. It is
[quoted text clipped - 19 lines]
>
> See your Doctor
Don Coon - 19 May 2004 16:36 GMT
Hi Steve,

Like the format and info contained in your signature.

Since I had RP on 3/29/04, my mind is naturally loaded with questions : )

First my info:

PSA 5.94 (from 3.7 year earlier) 1/4/2004 @ 62 (on 1/11/2004) What a
birthday present : (
Biopsy  2/23/04 G7 (3+4), T2c  not enlarged, good DRE
RP on 3/29/04, no complications.
Pathology following RP: G7 (4+3), all negative margins, lymphs negative, no
invasion of seminal vessels
PSA 5/17/04  0.03

Questions:

Do you recall your post-OP pathology report?
Are your PSA readings (.1 .1 .1 .3 .4 .8) quarterly?  That would seem
logical based on your EBRT date.

I won't yet bore you with the immediate questions on my mind --- like how
soon I can expect some semblence of continence, etc.  Erection in 2 years
appears a normal target : (

Cheers

> Ha!  Good advice.
Steve Kramer - 22 May 2004 02:29 GMT
Hi, Don.

> Do you recall your post-OP pathology report?

I am embarrassed to say that, once again, I forgot to get my records from my
uro.  During my first year or so, I think I was in shock or slightly
depressed.  I did not participate much in my treatment decision or research.
I don't know if my Gleason or Stage were changed post-op.  I do know that my
margins were clean, but there was some seminal vesicle invasion.

> Are your PSA readings (.1 .1 .1 .3 .4 .8) quarterly?  That would seem
> logical based on your EBRT date.

Yes, they were, more or less, quarterly.

> I won't yet bore you with the immediate questions on my mind --- like how
> soon I can expect some semblence of continence, etc.  Erection in 2 years
> appears a normal target : (

Don, it what we are here for.  Ask away.

I left my briefs behind me about 6 weeks after surgery.  I got rid of pads
probably 6 months after.  One day, I just realized I was throwing away dry
pads.  Erection came a lot later -- Surgery 12/15/2000, Erection 5/12/2003.

BTW, you'll get more reaction and faster reaction from me at
alt.support.cancer.prostate.  I only check this one out every week or so.

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA  .07 .05
Lupron 7/03, 8/03, 12/03, 4/04

Don Coon - 23 May 2004 15:50 GMT
Thanks Steve,

After I posted this I discovered alt.support.cancer.prostate.  Great
resource.

What irks me is the scarcity of information about regaining continence.
Other than doing Kegel exercises, I've found very little.  My otherwise
excellent Urologist has been very vague which leaves me to believe it's
primarily a natural recovery process.  Correct? I'd sure hate to discover
I'm doing something wrong.  If I am, the answers seem to be well hidden : )

I'm on pads at 8 weeks and have been told that 50% are continent, some with
safety pads, at 13 weeks. I've been doing Kegels and notice they're getting
prgressively easier to do.

If it wasn't for my HPC (Human Penil Clamp, i.e. thumb and forefinger ; )
I'd be going through twice as many pads daily.

I recently discovered the Squeezer Klip
http://www.squeezerklip.com/index.htm which is great!  It allows me to
attend functions I never could before using it. I can even golf with it on.
Having it on for 6 hours+ at a time without pain is easy.  Is this common
knowledge?  If not, I can be considered a strong endorser.

> Hi, Don.

SNIP

> > I won't yet bore you with the immediate questions on my mind --- like how
> > soon I can expect some semblence of continence, etc.  Erection in 2 years
[quoted text clipped - 8 lines]
> BTW, you'll get more reaction and faster reaction from me at
> alt.support.cancer.prostate.  I only check this one out every week or so.
jimhoney - 24 May 2004 00:08 GMT
Dr. Walsh's book (p. 246) says that use of a clamp will prevent you from
ever regaining control, because you will never develop the necessary muscle
control that way.

jimhoney
not a doctor
Don Coon - 24 May 2004 03:33 GMT
I really doubt that using the clamp about 5% of the time will make that much
difference. He was also against the condom catheter which a  number of users
employed and subsequently regained continence.

> Dr. Walsh's book (p. 246) says that use of a clamp will prevent you from
> ever regaining control, because you will never develop the necessary muscle
> control that way.
>
> jimhoney
> not a doctor
Steve Kramer - 24 May 2004 01:49 GMT
I've been content with my continence.  I'm sure you will hear from others
here, however, who have more experience at incontinence than have I.  Like
you said, it's a great resource.

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA  .07 .05
Lupron 7/03, 8/03, 12/03, 4/04

> Thanks Steve,
>
[quoted text clipped - 40 lines]
> > BTW, you'll get more reaction and faster reaction from me at
> > alt.support.cancer.prostate.  I only check this one out every week or so.
ButtercupsDad@dog.net - 24 May 2004 13:39 GMT
    I think this falls in the "we are all different" category.  I
was using 4-5 pads a day for months following the surgery.  Then in
February/March this year it slowed down to 1-2 a day, and at one point
I was throwing away pads that were soiled, but very light weight wise,
so not much there.  For some reason it got worse again though, not
more pads, but they are heavy again now, i.e., the leakage is worse.
No idea why.  
    On Kegels, I did those until I went back to work, and just got
too busy to ever think about that.  I may start again to see if over
time it does make a difference.  The uro has had me on several
different meds (although maybe all really the same basic drug) to know
effect that I can see.  
    For whatever it is worth, probably nothing, I would put away
that clamp and work on Kegels/diet/walking to try and get better
first.  If you use a "crutch" the body adjusts to that naturally.
There are times when that is needed, but don't make it the first
choice.  That advice is probably worth every dime you paid for it
(ha).
    Best of luck to you.  I just met a neighbor who had the
surgery twelve years ago and still has to wear a pad.  I am beginning
to wonder if I will be in that position too?
    Thank you.
David S.

>Thanks Steve,
>
[quoted text clipped - 39 lines]
>> BTW, you'll get more reaction and faster reaction from me at
>> alt.support.cancer.prostate.  I only check this one out every week or so.
Don Coon - 24 May 2004 14:14 GMT
Thanks for the response, David.

I agree with 95% of what you wrote.  Your experience seems to support my
thoughts that natural healing is the primary step toward regaining
continence. Kegels certainly help and are easy to do.  I typically do them
when I'm watching TV, reading, doing xwords or riding in the car.  If I do
them regularly it almost becomes a subconscious exercise.  I've eliminated
95%+ of caffeine from my diet and most alcohol although I was a very light
drinker before.

I agree and disagree on the clamp.  I feel that used sparingly it has little
negative impact.  By sparingly I mean probably less than an average of 1
hour per day. That means two hours one day walking nine holes of golf where
before I could go through three high capacity depends. Every swing,
including practice swings, results in a major spurt. Every step a minor
spurt. IMHO, the benefit of the exercise easily offsets any downside.  Try
going to a casino a couple times a months where the restrooms are easily a
100 feet trip and changing machines results in at least a major spurt and
usually voiding before you can reach a restroom.  Same with going to the
theater for a couple hours.   On the flip side, I don't use it for my daily
2 mile walk or around the house or while driving or while visiting close
relatives. I don't use it to attend a one hour investment club meeting.  I
probably use it less than 5% of the time -- a 5% that has significantly
improved the quality of my life. Time will tell.  I'm at 8 weeks and, per
Walsh's statistics, "almost" 50% of men are continent at 3 months. Hopefully
I'm in the 50% : )

Cheers.

Don

> I think this falls in the "we are all different" category.  I
> was using 4-5 pads a day for months following the surgery.  Then in
[quoted text clipped - 64 lines]
> >> BTW, you'll get more reaction and faster reaction from me at
> >> alt.support.cancer.prostate.  I only check this one out every week or so.
Dave Perry - 26 May 2004 05:00 GMT
Hi David S., Don, et al,

This is my first post in awhile, at least since I was reprimanded for
skewering the sacred Kegel cow.  I did get my uro to confess that
Kegel successes are stictly anecdotal.  I am nearly a year away from
my surgery and still leaking.  Down to 1-2 pads per day when I have
nothing to do except sit around and go to the bathroom.  Even then I
change only because I prefer the feel of a newly dry pad, not because
the old one is full.  If I have to move a lot, lift, or in general be
active I go through 2-3 pads per day.  One thing of note, I developed
a bad cough from allergies which has lasted about 3 weeks now and the
continence went out the window with the coughing.  One healthy squirt
per cough and I go through 4 or more pads per day just like the old
days (first month or two post op).  One thing of interest is that I
rarely get a full bladder except at night.  I start to leak long
before it fills and then I head to the can.  Have yet to experience a
full bladder during daytime activities.  Overall though things are
still improving.  Hope someday soon to switch to lighter pads although
I am pretty much used to the Depends.  Best of all, PSAs still good.

Low PSAs to all,
Dave Perry

> I think this falls in the "we are all different" category.  I
> was using 4-5 pads a day for months following the surgery.  Then in
[quoted text clipped - 63 lines]
> >> BTW, you'll get more reaction and faster reaction from me at
> >> alt.support.cancer.prostate.  I only check this one out every week or so.
ButtercupsDad@dog.net - 26 May 2004 12:56 GMT
Hello Dave:
    We are about in the same boat.  1 to 2 pads per day, more when
active like a couple weekends ago when the wifemaster had me lugging
around bags of mulch and planting flowers, etc.    I am thinking about
starting back on Kegels just to see if it does make a difference.  I
drink coffee too much I know, but my leakage was the same during the
period after surgery when I gave up the coffee, so I am not convinced
that really makes a difference.  My uro told me that he has patients
that drink lots of coffee and have no problem, so he didn't know
either.  
    One thing that may cause me a problem though is that I have
been diagnosed with high blood pressure, and if it does not come down
by the end of June the internist is going to put me on BP med's.  My
understanding is that they cause you to pee more, so that may
compromise my incontinence situation even more.  Will report as that
develops.  Getting old sucks.  
    Take care all.  
    Thank you.
David S.

>Hi David S., Don, et al,
>
[quoted text clipped - 86 lines]
>> >> BTW, you'll get more reaction and faster reaction from me at
>> >> alt.support.cancer.prostate.  I only check this one out every week or so.
Don Coon - 26 May 2004 16:06 GMT
Hello Dave S. and Dave P. : )

I'd love to be down to 1 or 2 pads per day ---- but it's only been 8 weeks
since my surgery so I don't have much grounds for complaining.... yet.  I'm
primarily using "man pads."  Interestingly, I've found that the store brands
made by Tyco are better than Depends.  They're slightly larger and cheaper
too,

Re BP meds: From what I read only alpha blockers are a problem. I've been on
a calcium channel blocker (Isoptin) for 12 years so I hope that's correct.

From the John Hopkins site:

"Men who take alpha blockers like Hytrin, Cardura, or Flomax can have
worsening of incontinence after radical prostatectomy because these drugs
relax the bladder outlet. They should not be used after surgery in men with
urinary control problems. There are many other options for blood pressure
control (e.g., calcium channel blockers), so alpha blockers should not be
necessary."

Don

> Hello Dave:
> We are about in the same boat.  1 to 2 pads per day, more when
[quoted text clipped - 106 lines]
> >> >> BTW, you'll get more reaction and faster reaction from me at
> >> >> alt.support.cancer.prostate.  I only check this one out every week or so.
David  S. - 27 May 2004 02:05 GMT
Don:
   Thank you for the info on the BP meds.  I will remember that when I have
my visit in July.
   Thanks again.  I hope you get some relief on the incontinence soon.
David S.

> Hello Dave S. and Dave P. : )
>
[quoted text clipped - 145 lines]
> > >> >> alt.support.cancer.prostate.  I only check this one out every week
> or so.
Leonard Evens - 29 Apr 2004 15:11 GMT
> I am in my 30's and male. A few weeks ago I noticed that I have a hard
> spot in my rectum about 4inches up it, maybe near my prostate. It is
[quoted text clipped - 17 lines]
>
> Any advice?

You shouldn't be trying to examine your own rectal wall.  Ask your
doctor about it.  It is most likely a normal part of your anatomy or
something of no significance.
dale.j. - 30 Apr 2004 01:26 GMT
> I am in my 30's and male. A few weeks ago I noticed that I have a hard
> spot in my rectum about 4inches up it, maybe near my prostate. It is
[quoted text clipped - 17 lines]
>
> Any advice?

Yes,

I would get a medical exam.  

I was told by one of my docs, not to try to self diagnose yourself.

Get it checked out.

Dale J.

Signature

Email:  dalej2@mac..com

Steve Kramer - 02 May 2004 01:52 GMT
> I am in my 30's and male. A few weeks ago I noticed that I have a hard
> spot in my rectum about 4inches up it, maybe near my prostate. It is
[quoted text clipped - 17 lines]
>
> Any advice?

See a doctor.
 
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