enlarged prostate

Factual Questions
1

Back in February, my father went into the hospital for congestive heart failure.
While there, he found he couldn’t urinate and they put a tube in.
they said it was an enlarged prostate.
He’s been home about a month and a half, still with the tube.
They took it out one day to see, and he said he wasn’t able to hold it, so they put it back in.
So i called the dr.'s today, and they said his blood level (for the prostate) was 21 instead of normal 10.
He has refused surgery cause he is 89 I guess.
They sai they don’t know if its prostate cancer, and may never know.

Does anyone know someone who has had this, or has any info?

2

It’s not at all unusual for men to develop an enlarged prostrate even in their 40s. There are drugs designed to shrink the prostate, and some doctors believe that saw palmetto may also help.

Most of the time, prostate enlargement is not cancerous, and needs no further treatment unless, like your father, it causes problems with urination. The “I can’t hold it” feeling comes from the bladder never fully emptying due to the enlarged prostrate constricting the urethra.

The blood test the doctor mentioned is designed to measure the presence of a particular hormone (or enzyme, I forget which) that is associated with prostate cancer. It is not, however, an absolute diagnosis. For that, he needs to have a biopsy.

Many doctors don’t like to operate on prostate cancer for men in their 70s or older. Prostate cancer is (generally) slow to spread and (so those doctors believe) a man is more likely to die of something else before the cancer causes serious problems.

Given your father’s advanced age and chronic health problem, both he and the doctor may well think that the risks of surgery for anything short of a life-threatening condition are too great. However, there are procedures that are less invasive than traditional surgery and might provide at least temporary relief. Your father could ask his doctor about those.

I understand and sympathize with your concern, but in this case it’s possible that the best thing to do is to do as little as possible.

3

Good info above. I’ve had the problem for a few years now, but no elevated level on the blood test. Saw palmetto (which is an over-the-counter herbal treatment) is somewhat helpful. The problem with the meds to shrink the prostate is that the side affects can be problematic.

4

First off, I’m not a medical doctor. Members of my family have had congestive heart failure and prostate troubles, though, and I can tell you the scraps that I know.

Congestive heart failure is a slow killer. The heart and lungs gradually stop working as they should. Your doctor can advise you as to how to keep the patient as healthy and comfortable as possible during the disease’s progress.

Prostate cancer is a VERY slow disease. It can be fatal, but it’s so slow that some patients choose not to treat it.

It’s your father we’re talking about, and it’s hard to speak plainly without seeming cold. However, two diseases are in a race to kill your dad. The surgery that would remove the prostate just might be more than the bad heart could take, and if it isn’t, the heart will fail before long anyway.

It’s a very difficult situation, vanilla, seeing your father fade away, and wishing there was something you could do. :frowning: We’re going through the same thing with my father-in-law.

As I said, I’m not a doctor. If I made factual errors, somebody will be along soon to set us straight. Be strong.

5

Well he eveloped symptoms in january swelling feet and hands and difficulty breathing.
He waited 3 weeks to go to the e.r.

They drained it all, and he came home 3 weeks later.
They just told him to avoid salt and keep checking his weight.

So chf is progressive?
I hadn’t known that.

6

Congestive heart failure is, essentially, the heart losing its power to pump as hard as it should. As the heart begins to weaken, fluid slowly begins to accumulate, mostly in the extremities, but also in the lungs. That can make it difficult to breathe. And yes, it’s progressive, in that the heart will continue to lose strength.

Depending on the stage of the heart failure, there are many treatments available. Simple diruetics can be very effective.

Once again, at your father’s advanced age, the doctor may feel that his condition is not yet serious enough to warrant the side effects that come with any treatment.

However, given your unease about your father’s treatment, I’d recommend your visiting his doctor (with your father, if possible) and raising the concerns you’ve raised here. Be sure and take notes – if nothing else, it usually persuades the doctor to give more precise answers.

If you still aren’t comfortable with the diagnosis and course of treatment, it’s time to get another opinion.

7

Pretty much echoing what has said before but also, the biopsy is a good idea. They can tell from the results not only whether it is cancerous but also how aggressive a cancer it is. I had a relatively aggressive prostate cancer but still had about six months or more to decide what to do. They held it at bay for that time with hormone shots. Gave me hot flashes but nothing else. The helpful but not conclusive blood test is for PSAs (Prostate Specific Antigens). Mine were up in the mid to high teens. Ideal is zero. There are false positives for PSAs as a diagnosis for prostate cancer, but the alternative explanation is an infection that should be treatable with anti-biotics. I opted for the surgery and the biggest bit of the recovery was getting toilet trained all over again. Took me about a month or two. Age 60.

The biopsy entails a little discomfort and I got pretty tired of it after about the tenth snip (they snip litlle pieces of the prostate in each of four quadrants) but it beats a painful death.

8

My dad has been on hormones for prostate cancer for several years now. He’s 80, and otherwise in decent health. I know they monitor his PSA, but not sure what else.

Best wishes for your dad. We found out our dad had this not long after we lost our mom to colon cancer. But so far, so good, in his case.

9

Sorry to hear about your father.

I went in for my annual physical and, being only 40, the nurse practioner opted not to do a prostate check. IIRC, there’s some question as to whether it is a good idea to get the PSA test too early, as false positives can occur and that then leads to a biopsy for what may not be cancer at all. There is then a record of “cancer” on your insurance that may (or may not) prove problematic down the road.

For what it is worth, my uncle was diagnosed with prostate cancer in 1970. He just died from it last year, at the ripe old age of 94.

10

Well, they said his PSA (blood test) was 21!

11

It’s good to know the number, but it’s not all that meaningful by itself.

Take a look at this
http://cis.nci.nih.gov/fact/5_29.htm

I know you’re worried about this. But don’t panic. Please talk to your father’s doctor and get his take on the situation.

12

PSA, as the name states, is an antigen the body produces, not a hormone or an enzyme. It can be elevated for a number of reasons, including enlarged prostate (BPH - benign prostate hyperplasia), infection, cancer, etc. After an episode of prostatitis a couple of years ago, mine was elevated to 19, when measured, but probably was higher before I saw a doctor. Informative, if you can get the info, is the number of free PSA, the higher the number the more likely it is cancer. But the only way to tell is by biopsy.

I assume you meant that he still wasn’t able to void, so the Foley cathether was put back in.

Last November, after surgery for an avulsed Achilles’ tendon, I had the same problem: not being able to void. I knew I had BPH, but was taking saw palmetto for it. I was catheterized in the hospital, but no Foley was put in. I was still unable to void (I was discharged in that condition), saw my primary physician two days later, who gave me Flowmax and was upset that I wasn’t taking the Flowmax (taking saw palmetto instead - which my urologist said was OK), but that didn’t help and I had to go to the ER, where a Foley was inserted. To make a long story short (or is it too late for that), I had to undergo laser surgery on the prostate and still had to use the Foley for a few days later. I had to wait two weeks for the laser, so I had the Foley in for about three weeks. After it was removed, and I was finally able to void, I had irritation you wouldn’t believe. My penis hurt like hell when I touched it or when I urinated. In addition, I had incontinence when farting or sneezing. Those symptoms slowly abated. I am now symptom-free, but with still a little pain around the prostate when doing abdominal exercises.

But the point is that your father cannot keep the Foley in indefinitely. The doctor said it was an enlarged prostate. That is not necessarily cancer. Most men’s prostates become enlarged after the age of 50 or so. The only way to tell is by the biopsy, and your father simply must have that done. It is a simple procedure, without the use of any anesthesia, and takes only a few minutes. It is, however, quite painful, as 6 needles are inserted through the rectum into the prostate. If he doesn’t have cancer, laser surgery is something that he simply must have, as he cannot, I repeat, keep a Foley in forever. He must have that done and take medicine for the prostate.

IANAMD.

13

My father developed an enlarged prostrate in his 50s. He ignored it until it was not ignorable any longer, at which point it was removed—this was forty years ago. Treatment options were limited. Anyway, by the time it was removed, he had damaged his bladder and had to self-catherize himself for the next 40 years. He eventually became unable to perform the task, but by that time he was in a nursing home. He died recently at 93, mostly because the machinery in general broke down. Just to illustrate that long-term catherization is possible, although certainly not advisable. My father was world class stuborn and the expression “hard-headed” doesn’t begin to describe him—he could have saved himself, and all of his family, a lot of trouble caused by bladder infections, penile cancer scares, etc., etc., if he had just had the damn prostrate treated when he first began to have trouble with it. If I had a point, I’ve lost it.

14

I am now going to celebrate the fact that I don’t have a prostate.