Urinary Incontinence after Radiation Therapy for Prostate cancer
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RP in August 2022. I regained continence 4 months post-RP, but had an overactive bladder (OAB) with some minor leakage which never got better despite physical therapy and other methods. PSA was non-detectable for about 10 months, then it rose to 0.08 by 12 months, then 0.12 by October 2023. This signaled a recurrence - so I started a 6 month course of androgen deprivation therapy (ADT) in November, then in late-December started 33 daily treatments of radiation to my prostate bed and pelvic lymph nodes.
During treatment my OAB got worse (although I had no incontinence) and there were bowel issues (radiation proctitis) - both common side effects of the radiation. It is almost 3 months since my last radiation treatment and there is no incontinence. However, I still have OAB (although it isn't as bad as when I was receiving radiotherapy), and the proctitis still lingers.
I believe some of my OAB is due to the ADT - it is a side effect. The ADT should be wearing off in a month, so hopefully the OAB and its other side effects will gradually disappear over the next several months. I understand (as a layperson) that there can be a delayed side effect of the radiation, where bladder and bowel issues can show up many months later.
Hope this helps.
During treatment my OAB got worse (although I had no incontinence) and there were bowel issues (radiation proctitis) - both common side effects of the radiation. It is almost 3 months since my last radiation treatment and there is no incontinence. However, I still have OAB (although it isn't as bad as when I was receiving radiotherapy), and the proctitis still lingers.
I believe some of my OAB is due to the ADT - it is a side effect. The ADT should be wearing off in a month, so hopefully the OAB and its other side effects will gradually disappear over the next several months. I understand (as a layperson) that there can be a delayed side effect of the radiation, where bladder and bowel issues can show up many months later.
Hope this helps.
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I had RP in December 2020 to remove a Gleason 9 cancer. At the three month point, my PSA was undetectable. I went in for a routine overall health check at four months, and the PSA came back at .021, so the oncologists recommended ADT and 40 sessions of salvage radiation. My incontinence had started really bad, but gradually and continually improved with kegels all the way through the radiation to the point that I was leaking only .1 to .2 ounces per day (which might have been just sweat since it was summer). However, at four months after radiation ended (11 months after RP), I suddenly started leaking again. First it was 5 ounces per day, then 10, and so on, as well as OAB symptoms. By 6 months post radiation (17 months post-RP), leakage was 40+ ounces per day. I was distraught and tried everything - many thousands of kegels, physiotherapy, and finally Botox injections into the bladder walls. My urologist finally convinced me to have an Artificial Urinary Sphincter (AUS) implanted, which I did 2.5 years after the RP. The AUS has been like a miracle. The OAB symptoms are almost totally controlled by taking Gemtesa once per day. Please understand, my trajectory is uncommon, affecting less than 5% of patients (so I was told). However, my urologist is superb, having written a chapter in a urology textbook on the AUS. Best of luck to you, and remember, the main thing has to be to defeat the cancer.
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Ricard, thanks very much for sharing your history. That helps a lot.
It is actually similar to they way I am going. I had my RP in September 2023 and At 3 months my PSA was undetectable. At 6 months it started to climb to 0.09 and now 7 months later it is at 0.13. My Gleason was nine. Unfortunately I still have some incontinence of which I have improved to one to two ounces per day compared to probably three to four before. I have an appointment at the MD Anderson next week where I will be tested with imaging and they will offer me a treatment. From what I have read I probably will have ADT and Salvage radiation therapy. I had mentioned before that I use the Emsella chair which seem to have help some with incontinence, in addition of the Kegel exercises that I continue to do.
Thanks for your information. Is very helpful.
I wanted to ask you about the side effects of the radiation And the ADT. How bad was it and what kind of symptoms did you have. At what Center were you treated for the RP, the RT and the AUS?
It is actually similar to they way I am going. I had my RP in September 2023 and At 3 months my PSA was undetectable. At 6 months it started to climb to 0.09 and now 7 months later it is at 0.13. My Gleason was nine. Unfortunately I still have some incontinence of which I have improved to one to two ounces per day compared to probably three to four before. I have an appointment at the MD Anderson next week where I will be tested with imaging and they will offer me a treatment. From what I have read I probably will have ADT and Salvage radiation therapy. I had mentioned before that I use the Emsella chair which seem to have help some with incontinence, in addition of the Kegel exercises that I continue to do.
Thanks for your information. Is very helpful.
I wanted to ask you about the side effects of the radiation And the ADT. How bad was it and what kind of symptoms did you have. At what Center were you treated for the RP, the RT and the AUS?
Archives1
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Hi Leonghitis,
In response to your question, my Gleason score was 8. Stage T3a. Positive margins (which I suspect was a factor in the recurrence).
Just over 2 months after my last radiotherapy treatment my PSA was non-detectable (<0.01). Good news, but maybe not so surprising given that the ADT starved the PCa. My next PSA is scheduled for Oct. The 6 months of ADT ends next month, so by Oct my testosterone levels should be back up and I may have some indication that the earlier combo of ADT and radiotherapy did its job. Praying that this will be so.
Thanks Greg8 for your thoughts.
In response to your question, my Gleason score was 8. Stage T3a. Positive margins (which I suspect was a factor in the recurrence).
Just over 2 months after my last radiotherapy treatment my PSA was non-detectable (<0.01). Good news, but maybe not so surprising given that the ADT starved the PCa. My next PSA is scheduled for Oct. The 6 months of ADT ends next month, so by Oct my testosterone levels should be back up and I may have some indication that the earlier combo of ADT and radiotherapy did its job. Praying that this will be so.
Thanks Greg8 for your thoughts.
Archives1
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Hi Leonghitis,
I'm in British Columbia Canada, so my experience is from the Canadian healthcare perspective. My diagnosis, tests and ultimately my RP was a local urologist who is very experienced. When my PCa recurred, I was referred to a Radiation Oncologist at the BC Cancer Agency (I happen to live in a city with a Cancer Treatment center) so my ADT and radiotherapy were all done there.
Take care.
I'm in British Columbia Canada, so my experience is from the Canadian healthcare perspective. My diagnosis, tests and ultimately my RP was a local urologist who is very experienced. When my PCa recurred, I was referred to a Radiation Oncologist at the BC Cancer Agency (I happen to live in a city with a Cancer Treatment center) so my ADT and radiotherapy were all done there.
Take care.
Archives1
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Leonghitis: I had the first ADT shot two weeks before beginning the 8 weeks of RT, and the second shot four months later. I never stopped physical exercise, which helped. My side effects were as predicted - some physical fatigue, hot flashes, loss of muscle mass with concomitant gain in belly fat as my testosterone zeroed out. Later came the incontinence that I mentioned in my earlier post.
I was on active duty when the docs discovered the cancer, so my RP, ADT, and RT was done at Walter Reed. I then retired and was handed off to the VA, who then farmed me out to my superb urologist in Titusville, FL. I had the AUS implanted in Titusville at the Parrish Medical Center.
I was on active duty when the docs discovered the cancer, so my RP, ADT, and RT was done at Walter Reed. I then retired and was handed off to the VA, who then farmed me out to my superb urologist in Titusville, FL. I had the AUS implanted in Titusville at the Parrish Medical Center.
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