I have the same question/problem

I’ve found information on this forum for everything conceivable related to health and triathlon. Interesting that search of the forum didn’t yield anything on this issue.

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After Covid it has been challenging to get doctor appointment in person

Get in to see a doctor in person. Don't take "no" for an answer. Your symptoms are fairly severe-sounding. You need a doctor to stick a finger up your rectum and feel the prostate. Both to see if it's a) enlarged, and b) if it's enlarged, feel if the texture is consistent with benign prostate enlargement (BPH) or a cancerous enlargement.

Also since you didn't mention it, I'd get a PSA test for confirmation. Because why not.

It seems bananas to me to start trying antibiotics and alpha blockers without a definitive diagnosis of your problem.

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Im reluctant to just go med with no end game that treats symptoms but no cure

If you indeed have BPH (benign prostate enlargement), there is no "cure" outside of pretty invasive surgeries that all have significant risks, like permanent impotence or ED. Flomax to treat the symptoms might be preferable on the risk spectrum.

fwiw, I had less severe BPH (no issues working out or racing, but had to get up once per night, which was slightly annoying). Flomax helped just a bit. But I quit using it when my symptoms lessened a bunch for no apparent reason. I don't have the pee stream of a college student at a kegger, but it has near-zero impact on my life at the moment.

Pretty much all this. Get the exam.

My story (starting age 62; now 64). Frequent urination (nocturia and on the bike). Prostate 4x normal size (literally), PSA highly elevated. I thought I was doomed. Exam showed smooth prostate, and MRI (in preparation for a biopsy) showed nothing suspicious. Been on Flomax ever since (almost free, and no side effects I know of (well, except for *that* one)). Sometimes it works better than other times, but for the most part life is okay. I managed to do seven centuries in 2022 without peeing on myself.

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"Go yell at an M&M"

Note: This is not medical advice.

You need to get an actual exam.

Discuss prostatitis with your doctor, in particular, the effects of caffeine and/or alcohol if you use either. I have had a lot of patients who relied on caffeine to keep them moving (several cups of coffee / energy drinks per day), which resulted in prostatitis. Getting them off caffeine plus a short course of flomax helped tremendously. This may not be your problem at all, of course, but it is worth the discussion

Phil

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Dr. Philip Skiba
Scientific Training for Endurance Athletes now available on Amazon!

I did take Flomax, but the side-effects caused me to switch it a less effective medication.
It seems that some BPH medications have side-effects. Same for some high blood pressure meds.

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Kevin

I had an in person doctor appointment this morning.

The doctor agreed I took the appropriate step by getting in person visit before proceeding. The doctor took time to query all symptoms and did an exam. Also, doctor ordered blood and new urine test.

The athletic paradigm of this forum in relation to various health or injury issues is very valuable.

I really appreciate all responses!!!

Did the doctor mention that the PSA test can be affected by sex and/or biking prior to the blood draw?

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"Go yell at an M&M"

Doctor specified that I wait until antibiotics cycle is complete before these tests however, did not mention either sex or cycling affects.

Also, don't take Flomax before Cataract surgery.

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Kevin

Note, I'm in the UK. I had same problems as you, more frequent visits to pee at night, much reduced flow rate etc. I put it down to old age, as I turned 60 in January this year.

My wife nagged me to get a PSA test in Feb, so went with a mail in test and results came through that I had a PSA of 75, normal range for men my age is up to 4. They suggested i go to my local GP and they did a test for urinary infection (all clear) and then did another PSA test. Result came back with PSA of 77, so got appointment at hospital for a DRE (finger up bum) then a biopsy and MRI scan.
Result came back that I have aggressive advanced prostate cancer, luckily its not spread to any organs or bones so far, but basically it's incurable and I'll be on treatment for life.

The motto of this story is that if you're over 50 and have any "night issues" then please get a PSA test before it's too late. If go further and get checked in any case...its free in the UK.

If I'd gone a year or so earlier when I first noticed symptoms they'd probably have caught the cancer early and could cure it...I was too late.

So sorry to hear that. Best of luck, and thanks for sharing your story. Hopefully, it gets some people off their butts to get medical guidance.

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"Go yell at an M&M"

Thanks. I've come to terms with it pretty good. Still able to run, bike and swim but at much reduced intensity as the hormone treatment stops any testosterone being produced. Side effects aren't too bad, just hot flashes.

I no longer have a prostate because it had cancer and I chose to have it removed (which is a different thread). Point is I can pee like a college kid again, but I still have to get up several times a night if I have a beer or two after dinner. I try to stay hydrated, but it comes at a cost of not sleeping through the entire night.

I'd like to 2nd the thank you for sharing. I'm sure your story will help many by provided the motivation to keep an eye on the PSA numbers.

My Dad had prostate cancer at around age 55 so I've been pretty conscientious about getting my PSA number checked at least annually. My last check was this past August.

Knowing that more frequent urination is an indicator for multiple ailments including prostate cancer, I got right on the issue. A few hiccups getting into the doctor but, on the right track now to checking fully evaluated.

All the best to you!

I no longer have a prostate because it had cancer and I chose to have it removed (which is a different thread). Point is I can pee like a college kid again, but I still have to get up several times a night if I have a beer or two after dinner. I try to stay hydrated, but it comes at a cost of not sleeping through the entire night.[/quote]


TJ56, I'm curious why you chose to have the prostate removed as opposed to a different form of treatment. Would you consider the result successful? Would you make the same choice if you had it to do over? I was just diagnosed with prostate cancer, mostly Gleason socre 6-7and Grade Group 3. I'll be determining my treatment plan soon and have considered prostate removal as my father had prostate cancer and it eventually metastasized to his bones and I want to eliminate that potential.

Jumping in here to extend the thread hijack - maybe we need a new thread - but I have an annual exam with PSA. PSA had been rising, but still below 4 ng/mL. Jan 2022, PSA was 7 ng/mL. I thought that this was still pretty much a non-issue, but proceeded with more assessment. DRE, MR imaging with contrast, biopsy. Aggressive PC with a Gleason of 9 (out of 10). Had a radical, total, robot-assisted prostatectomy in late August after a bone scan and consults with surgeons and radiation oncologists (including a former PhD student!).

The take home message is that PSA is more about the extent (size) of the disease and less about the aggressiveness. My cancer was small-ish (relatively low PSA) but very aggressive. I'm just a few months out, so the future is very uncertain. But, right now, my PSA is undetectable and I am in a 'watchful waiting' phase getting PSA tests regularly. That could change at my next PSA test...

Bottom line - PSA rising = potential serious issue = get checked ASAP. If it is BPH, treat it if you need to. If it is PC, treatment earlier = minimize treatment(s), fewer side effects and better outcomes, including QOL. I don't know why I did not investigate when my PSA rose from 0.5 to 3.5 ng/mL over the course of 4-5 years. Something was up and that something could have been addressed far more easily even a year ago.

Not medical advice, I'm a Ph.D. 'doctor' - just my experience.

For me trying to decide the treatment for the disease was just as stressful as being diagnosed. There seemed to be so many solutions back in 2016, each with different pros and cons. Without writing a long post I’ll say that I was told if went the surgery route and the cancer came back I would have radiation options whereas if I chose radiation first there is no longer a surgery option. And I just got my PSA score last week and it’s still .00 something. I’m very satisfied with my QOL at age 66.

Right. This is still true today and one reason I chose surgery 1st (and, hopefully, only) over rad onc. There is also the irrational, but real, perception that it's better to 'get it out' surgically than to trust the 'invisible' rad onc treatment. Yeah, it's all invisible, but you can imagine... Much also comes down to the extent, type and timing of the negative side effects that are different among treatment choices. But the bottom line, for me - rising PSA no matter if less than 4 ng/mL - get it checked. Nothing to lose by getting a detailed Dx early, but much to lose getting that same Dx a year or three later.

Sorry to hear of your diagnosis, but stay positive.
My father was diagnosed with a combo of gleason 9 & 10 scores, stage 2 - I think it had just spread to seminal vesicles but no further.
He was treated with lupron to lower the testosterone to zero, then treated with a combo of low dose taxotere (sp?) chemo, and IMRT.
That was roughly 12 years ago, he was fully cured, is now in his 70's still out golfing, etc.

Sorry to hear about your experience. Mine was Gleason 9 too, but unfortunately mine had spread to lymph nodes in my pelvis, back and clavicle, so much too far gone for surgery.
I'm stuck on hormone treatment for life now and to be fair my quality of life is fine, but it is quite humbling how the reduction in testosterone has affected my bike and run. Lost about 25% of bike power, using FTP test, and am about 20% slower over 5k distance in about 5months. Just got to get used to the new normal and be thankful I can still do swim, bike and run. Got the London Marathon in April as my first goal!!

Best of luck with the recovery

Great information everyone. I've learned so much over the past couple of weeks about PC and treatment options. I was fortunate to get an appointment at the Mayo Clinic in Rochester MN and after consulting with the doctor I've elected for prostate removal with the goal being to eliminate the cancer. I'm also planning on a PSMA PET/CT scan which is newer technology that will detect any spread of the cancer to other parts of the body. Although the risk that the cancer has spread is low due to PSA value I don't want to take any chances. I'm looking forward to the procedure and moving forward.

Can anyone comment on the recover process and time to do so?
How long before swimming? Running? Biking?
Any recommended do's and do nots?
Any input on the side effects such as dealing with ED and/or leakage?

I will have surgery in mid-January 2023 and am registered for a 70.3 in the beginning of July....based on your recovery process is this going to be feasible for me?

thx

I walked the first month. Pretty sure I was back to swimming after that. Maybe a touch longer for running. I gave it 3 months for the bike. I had to be careful where I sat on the seat. If you sit in that "wrong" spot you will get immediate feedback :) Fortunately I learned how to avoid that wrong spot and had no problem riding. Fast forward maybe a year and that "wrong" spot no longer exists and I think I'm actually more comfortable on the saddle than before surgery. Major leakage no problem. Maybe some minor leakage now every now and then. Black bike and running shorts take care of that. ED? Doc told me he was able to save 75% of my erection nerves. So I took a 25% hit. That and I'm age 66 so all I'll say is that Cialis is my favorite PED.

Be sure to get insurance approval for the PMSA-PET. I was unable to get coverage for that, so I made my decision based on a bone scan, which is far less useful (but not useless). I am 15 weeks out from my prostatectomy. PM me if you want details, ask Q, etc.