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Crystoscopy after RP and radiation therapy

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Prostate Cancer
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Posted 3/21/2020 1:54 AM (GMT 0)
Hello...I'm a patient at Emory. Initial diagnosis 9/17 with PSA 11. Biopsy was Gleason 3 4. Surgery with follow up radiation after PSA detected at .08 and rose to .14. I had positive margins. First PSA test after radiation reduced PSA to .09 and .05 6 months later. My PSA rose in January 2020 back to .09. Oncologist says wait and see trend. I had blood in urine last week, just a trace but noticeable. Seemed to stop a day later but called Emory and got a urology PA that advised it was common, take wait and see and monitor and she would consult my RP surgeon. Five days later they schedule for a cystoscopy. April 10th.. Any idea what could have happened? Why the reversal now? With Covid 19, there are no unnecessary surgeries to preserve masks etc. Why the change? Could it be bladder cancer? I know this is limited info, but any good opinions would be appreciated. Thank you.
Posted 3/21/2020 8:53 AM (GMT 0)
Bagman, I think it's kind of good news in that you quickly get to see what's happening. Blood in urine seems to occur sometimes after radiation as some blood vessels in that area may have been affected. My guess is a free slot has opened up - maybe a cancellation or maybe Doc wants to fit you in now thinking there may be a longer delay down the road.
Posted 3/21/2020 2:00 PM (GMT 0)
Bagman, I had a similar event. RARP in Sept 2016 with BCR after 6 months which was treated with IMRT and Lupron. One day in Sept 2019 I had blood and some blood clots for about 6 hours, a urogram found nothing and a cystoscopy was unable to get into the bladder. Urologist said it was a bladder neck contracture due to scar tissue from surgery and radiation. It was dilated and bladder looked normal and good. It is something to keep an eye on, if it would close up the inability to empty the bladder is very uncomfortable. This is hopefully an isolated and minor side effect, but after being told we have cancer any new symptom seems to send our anxiety into overdrive. Stay positive, it is better that your Dr's are being proactive rather than dismissing your symptoms.
Posted 3/22/2020 2:27 PM (GMT 0)
Bagman, we had something similar, also at Emory. Randy had a long unhappy nightmare involving an AUS (the details are in other posts). Six weeks after the removal, Randy was still having quite a bit of blood in his urine after every BM. I called, and was assured that, having had radiation, the healing time is longer and this was perfectly normal. If it got worse, or didn't clear up after a couple more weeks, they would schedule a cystoscopy. Then, about an hour later an appointment appeared on the portal. No explanation. I'm guessing they went ahead and put Randy on the calendar, just so we'd have an appointment if needed. We have since canceled it, since the bleeding has all but gone away, and we have no intention of sitting in any waiting rooms that we can avoid.

Donna.

Post Edited (RandyJoe) : 3/22/2020 8:33:17 AM (GMT-6)

Posted 3/22/2020 5:09 PM (GMT 0)
Please go ahead with the cysto.
My treatments were HDBRT and EBRT. One year after the treatments, Blood clots and blood in urine, difficult to start. Went to see a uro, he wanted to do a cysto but I Postponed the cysto and went on vacation. While on vacation, had a complete blockage urinary stricture, unable to void. Treatment was extremely painful. Mine is an extreme case. They tried to dilate but failed, ended up with DVIU.

Please take this opportunity to find out if there is anything wrong, may just be dead blood vessels from radiation, easier to take care of. My uro does not know what caused my stricture and definitely not blaming radiation.
Posted 3/23/2020 1:45 AM (GMT 0)
I am following these posts with interest. My husband has had two episodes of blood in his urine over the past several weeks and passed a small clot each time. He is about 18 months post RALP and finished radiation treatments about 10 months ago.He is also currently on bicalutamide which apparently can also cause blood in the urine. His MO doesn't think its cancer related, but he will be following up with his urologist.
Posted 3/23/2020 1:49 AM (GMT 0)
I agree... get the cysto if offered. You might as well see what is going on, although blood in urine, mostly micro hematuria, that you can’t see happens months to years after radiation. Gross hematuria is a little more alarming because we can see it and it is a sign that something needs to be looked at. The cysto May let you know. When it happened to me, my MedOnc had me do a CX bladder cancer test. Simple urine test that uses the blood to detect any cancer. However you need to see if your insurance covers it. The last thing you want is to have a stoppage! Good luck on your tests. Stay healthy! -JR
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