Treatment with Radiation Therapy
Side Effects of Treatment
Diet, Lifestyle and Nutrition for Prostate Health
After a long run with prostatitis and BPH, this mid-pack marathoner’s diagnosis with prostate cancer at age 55 – followed by nine weeks of treatment with Image-Guided Radiation Therapy – led to a blog, a book and fundraising for a cure.
Somewhere along mile 21 of the Chicago Marathon, I noticed something was terribly wrong. Not a knee, not a cramp. My crotch was on fire. I had to go so bad, it burned. So I hit a Port-O-Potty and out flowed dark red urine. A stream of burgundy. It was the first time I’d seen so much blood in my pee, and I have to admit, it freaked me out.
That wouldn’t be the last time, however. In over a dozen future marathons and half marathons in New York, Palm Beach, Miami, again in Chicago – and too many training runs to count – a fiery burning sensation would send me off into the weeds only to see the red urine flow. Or, there would be the overwhelming urgency to go, but nothing there, except a red drop or two.
Sad to say now, but I got use to this-over eight years. I accepted occasional bloody urine. Just as I “lived with” chronic prostatitis, which led to the frequent bladder and urinary tract infections, which caused all sorts of havoc in my plumbing system: leaking, urgency, hesitancy, burning, the blood. When things got really bad, my doctor would test my urine for an infection, then put me on another round of antibiotics for some temporary relief. But nothing permanent, the problems always returned, and got worse.
Finally I landed in an ER with acute prostatitis. Infection had squeezed shut my urethra, preventing me from peeing at all, my bladder backfilling like a water balloon. When a doctor threaded a catheter up my penis, 800 milliliters of urine – about 2 ½ times a normal full bladder – filled a bag next to my bed. Trust me, you want to pass on that experience.
Six months later, at age 55, I was diagnosed with prostate cancer. Was there a connection? I didn’t know, I’m not a doctor. But prostate cancer begins long before somebody tells you that you have it – with genetics, or aging, or diet. Or maybe because of chronic prostate disease like the one I had. Like a lot of guys have.
I learned about the cancer after an annual checkup, when my PSA had spiked from 1.0 to 6.6 ng/ml. Because of my history with prostatitis, my doctor put me on antibiotics again for a month. But my PSA level remained up, so he recommended a biopsy. When the pathology report came back, it revealed an enlarged prostate filled to the brim with prostatitis (inflammation and/or infection), and two microbits of cancer.
So in the spring of 2008, I underwent 48 sessions of targeted, high-dose radiation – Imaged Guided Radiation Therapy (IGRT). My urologist had told me my cancer was “aggressive” but likely localized in the prostate. He assured me my chance of survival was extremely high, around 95 percent – as long as I had some kind of aggressive treatment. Either surgery or radiation. With a Gleason score of 7, he said doing nothing (active surveillance) was not an option. He recommended surgery, as most surgeons will do.
But I was very uncomfortable with the potential collateral damage from surgery – dreaded incontinence and impotency. So I consulted a radiation oncologist who told me that IGRT would give me an equal chance of a cure, but with a lower risk of side effects. He explained that IGRT could deliver super high doses of radiation to my prostate, actually targeting the cancer, with little if any impact on neighboring organs, like my rectum or sensitive nerve bundles associated with sexual function. To be fair, he qualified the risks and benefits, but in general he sold me on IGRT as the cutting-edge in precision radiotherapy.
As these things go, it sounded great to me. No hospital stay, no blood, no cutting around the equipment, no catheters. Despite several doctor-friends advising me that surgery for a guy my age was the way to go (“the gold standard treatment” for mid-fifties boomers), I elected to go with IGRT. To me, survival was no longer the issue, as much as my lifestyle after treatment. And IGRT seemed less risky.
Three years later, did the promise of IGRT pan out? Not exactly, but I have no regrets either.
The good news is my PSA dropped to a normal 1.0 ng/ml, and seems to be holding. But I now suffer nasty bouts with overactive bladder syndrome, likely the result of radiation singeing my bladder. Rectal burn and hemorrhoids hung around for months after the treatment, but eventually cleared up. What seems to be more long lasting is mild ED, which is helped with Viagra and Cialis. Not a big deal.
Interestingly, the high-dose radiation seems to have shrunk my enlarged prostate, from a small apple to a walnut again. “Soft, supple, normal-sized” was how my doctor put it. It also eliminated my frequent bouts with prostatitis and bladder and urinary track infections. Although I should note: The radiation knocking out all my old plumbing miseries may have been a bonus, not a guaranteed outcome.
As I became part of the prostate cancer world, I couldn’t help but wonder if my long battle with worsening prostate disease and UTI issues were linked to the cancer? Did one lead to the other – as advanced inflammation in the esophagus (Barrett’s Syndrome) may lead to esophageal cancer? Or as chronic colon inflammation (colitis) may advance to colon cancer? So, does chronic prostatitis set the stage for prostate cancer? Could a better diet have helped me years ago? Supplements? Acupuncture? Anything?
Several doctors told me the same thing, that there was no hard science connecting prostatic inflammation (prostatitis) with prostate cancer. One dissenting physician, however, was emphatic, saying “they were all connected” and that there was a growing body of science to back him up.
Who was right? Blogging on my prostate cancer journey, I found leading researchers like Johns Hopkins Research calling prostatic inflammation “a primordial breeding ground for cancer” and a “smoking gun” for prostate cancer development. Autopsy studies showed prostatitis and prostate cancer co-exist nearly 100 percent of the time. Though controversial and complex, study after study now cites inflammation as a potential major risk factor, along with age and genetics. Many physicians and researchers even take it a step further, saying that an anti-inflammation diet (low fat, low sugar) may help reduce prostate disease and, in turn, prostate cancer.
At my wife’s urging, my blog on all this turned into a book, The Prostate Storm. Half of the book is my personal journey, as a newbie cancer host dealing with a diagnosis, treatment and its aftermath. I also write about my brief experiment with holistic medicine as a prostate cure-all, and a blood clot discovered the week of my diagnosis, another cancer surprise. Plus there’s research linking prostatic inflammation with our high-fat Western diets, the basics of an anti-inflammation diet, and other topics.
My goal is to use some of the proceeds of the book, as well as fundraising runs, to support research for a new prostate cancer screen and ultimately a cure. The hope is that by contributing to this cause today we will help to spare our sons tomorrow.
My best to everyone,