Chronic Prostatitis pre treatment: radiation or surgery ?

Posted by carl123 @carl123, May 13 12:19pm

Hi All:
Have any of you with prostate cancer also had chronic prostatitis pre treatment? If so, what treatment did you select - radiation vs surgery?

I've been told by some that radiation will exacerbate symptoms and by others that it will exacerbate the symptoms for several months, but after that the symptoms should improve to better than pre-radiation.
I've also heard that surgery, while it does remove the prostate, does not solve the prostatitis symptoms. I'd appreciate any counsel.
The chronic prostatitis is non-bacterial as far as we can tell.
Thanks

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Jeff Marchi | @jeffmarc | May 13 2:37pm

This is the situation where you should get a Prostox test to see if radiation will cause you problems. That test can tell you whether IMRT or SBRT can cause long-term issues.

If you could get more sessions of IMRT That would allow them to use less radiation and might avoid the problem with the urinary issues. I know many people that have had I MRT in 20 sessions or around that number and they almost always have urinary issues. I had eight weeks of sessions 12 years ago and didn’t have any problems. Lower dosage might’ve been the reason or better techniques, though that’s unlikely.

Surgery would definitely greatly reduce the problem potential.

brianjarvis | @brianjarvis | May 14 5:35am

Have you considered treating the prostatitis first, and then dealing with the prostate cancer once that’s resolved?

bjroc | @bjroc | May 14 6:01am

Is this BPH with prostatitis, or just plain prostatitis? What is the prostate size?

marlon | @marlon | May 14 7:25am

If the prostate is gone (via surgery) how could it be irritated (prostatitis)? I had BPH prior to surgery and it went away with my prostate.

heavyphil | @heavyphil | May 14 7:54am

If you elect surgery, your prostatitis will disappear, along with your prostate; however, there are always continence issues to be mindful of.
But radiation can make urinary issues worse, so as others have suggested, the Prostox test is critical.
Some on the forum have had TURP or HoLep procedures done prior to radiation in order to lessen the SE’s of treatment.
You really need to have an in depth discussion with an RO and your urologist if radiation is your chosen treatment. Best,
Phil

carl123 | @carl123 | May 14 12:53pm

In reply to @bjroc "Is this BPH with prostatitis, or just plain prostatitis? What is the prostate size?" + (show)

It is chronic prostatitis, and as best we can tell non-bacterial.
I reviewed the literature, and removing the prostate via protectomy does not guarantee that symptoms will abate. In fact, they can get much worse.
I'm considering the Rezum.
I also found some literature stating the radiation will worsen the symptoms short term but can dramatically improve them long term. See Scholz you tube " Radiation and Prostatitis.
Thanks to all for your responses.

carl123 | @carl123 | May 19 11:10am

In reply to @brianjarvis "Have you considered treating the prostatitis first, and then dealing with the prostate cancer once that’s..." + (show)

@brianjarvis
He already tried that and needs to move on with treating his cancer. Thanks

carl123 | @carl123 | May 19 11:14am

In reply to @marlon "If the prostate is gone (via surgery) how could it be irritated (prostatitis)? I had BPH..." + (show)

@marlon

Thanks. Surgical removal for chronic prostatis has been tried numerous times and the studies show that more often it makes the symptoms worse. There are many references on this . It is a complex problem.