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DocPhilMD
DocPhilMD, Medical Doctor
Category: Oncology
Satisfied Customers: 54184
Experience:  Internal Medicine Doctor
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Dear Sir/Madam,I am a 59 year old male who was diagnosed

Customer Question

Dear Sir/Madam,
I am a 59 year old male who was diagnosed with bladder cancer in the bladder neck T1 High Grade 2 years 5 months ago .... Initially the consultant using the flexible cystoscopy found no abnormality but subsequent fixed cystoscopy found the problem to his shock as the cystoscope was being removed and by accident also found I had prostate cancer.Biopsies confirmed the cancer staging following histology results.I have had 2 turb's and regular monitoring with 6 monthly flexible cystocopies.I have been having Mitomycin C & BCG Instillations.I have high urine protein and have had no love life for over 2 years! ...I have regular firm erections but cannot reach orgasm as at the point of ejaculation and orgasm as chronic pain stops me proceeding further. My marriage ended sadly as a result.My BCG had to be stopped 4 weeks ago because it was burning my bladder and I was passing blood,bladder tissue and blood clots.I have regular urges to urinate which causes chronic right kidney pain and I often pee myself because I cannot reach the bathroom quickly enough.

I am looking for answers from an understanding doctor of urology who takes the hippocratic oath seriously enough to answer without charging me a fee because I am sick and my income procludes me eating properly and paying bills and I am soon to lose my home.

Please help me,I am depressed and at my wits end.Is life worth living anymore ...I wonder? ... Is my prognosis bladder removal and subsequent death?
Submitted: 3 years ago.
Category: Oncology
Expert:  DrThomasMd replied 3 years ago.
Hello from JA
The erectile dysfunction and incontinence can be from two TURPS.

What is your exact question?
Customer: replied 3 years ago.

I did not say I have or had erectile dysfunction and I have had 2 TURB'S ... not TURP'S the latter relates to the prostate not the bladder ??? ...


 


You must read as well as you write ...


 


And you are a doctor ?


 


God Help Us !!! ...


 


 

Customer: replied 3 years ago.
Relist: Inaccurate answer.
Expert:  DrThomasMd replied 3 years ago.
Yes I see, 2 turbs is what you said above

I think you must have meant turbts, trans-urethral resection of a bladder tumor....
Is that correct
So what was done about the prostate?

Erections and not able to reach orgasm would possibly be a form of erectile dysfunction, but I take it that it is orgasmic dysfunction only.

So, again, what is your exact question?
Customer: replied 3 years ago.

I meant what I said initially trans - urethral resection of the bladder followed by re-resection of the bladder. (2 x TURB's) ...


 


Regarding my prostate cancer I had a core needle biopsy and this is being followed by way of Prostate Specific Antigen (PSA) testing ... until brachytherapy proves necessary.


 


I do not have any form of erectile dysfunction.I have anorgasmia as a result of chronic pain at the moment of anticipated orgasm and ejaculation.


 


If you read my original mail you will see this is a multi - layered question to a complex array of debilitating symptoms.


 


Your answers must specifically relate to my original mail ...

Expert:  DrThomasMd replied 3 years ago.
What have they staged the bladder cancer at currently
Customer: replied 3 years ago.

T1 High Grade 3

Expert:  DrThomasMd replied 3 years ago.
By grade 3, to you mean stage 3, which has spread through the muscle wall of the bladder?

Yes, this requires bladder removal and chemotherapy.

If the cancer has not spread beyond stage three, I do not think this means a death sentence.

Average 5 year survival for stage 3 is 46%.

So this means than some liver many more years than that with treatment.

If the cancer has not spread to nearby organs....longer survival.

OK. If you have further questions or details, use reply to expert.

Otherwise please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.

Expert:  DrThomasMd replied 3 years ago.
Hello
Did you have further questions?
Customer: replied 3 years ago.
Relist: Answer quality.
Expert:  DrThomasMd replied 3 years ago.
Hello again.

What question is not answered for you?
What specifically do you still want to know?

The numbers above are accurate averages.

Is there some confusion...the only question I see in your post is, do I have to have my bladder out, and you also ask about mortality.

Is there something else?
Customer: replied 3 years ago.
Relist: Incomplete answer.
Expert:  DocPhilMD replied 3 years ago.
Thank you for this relist.

I would like to help.

Can I be of assistance to you today?
Customer: replied 3 years ago.

Dear Sir,
I am a 59 year old male who was diagnosed with bladder cancer in the bladder neck T1 High Grade 2 years 5 months ago .... Initially the consultant using the flexible cystoscopy found no abnormality but subsequent fixed cystoscopy found the problem to his shock as the cystoscope was being removed and by accident also found I had prostate cancer.Biopsies confirmed the cancer staging following histology results.I have had 2 turb's and regular monitoring with 6 monthly flexible cystocopies.I have been having Mitomycin C & BCG Instillations.I have high urine protein and have had no love life for over 2 years! ...I have regular firm erections but cannot reach orgasm as at the point of ejaculation and orgasm as chronic pain stops me proceeding further. My marriage ended sadly as a result.My BCG had to be stopped 4 weeks ago because it was burning my bladder and I was passing blood,bladder tissue and blood clots.I have regular urges to urinate which causes chronic right kidney pain and I often pee myself because I cannot reach the bathroom quickly enough.


 


This as you will see is a multi-layered question! ... in addition how do I get my love life back?

Customer: replied 3 years ago.

Dear Sir,
I am a 59 year old male who was diagnosed with bladder cancer in the bladder neck T1 High Grade 2 years 5 months ago .... Initially the consultant using the flexible cystoscopy found no abnormality but subsequent fixed cystoscopy found the problem to his shock as the cystoscope was being removed and by accident also found I had prostate cancer.Biopsies confirmed the cancer staging following histology results.I have had 2 turb's and regular monitoring with 6 monthly flexible cystocopies.I have been having Mitomycin C & BCG Instillations.I have high urine protein and have had no love life for over 2 years! ...I have regular firm erections but cannot reach orgasm as at the point of ejaculation and orgasm as chronic pain stops me proceeding further. My marriage ended sadly as a result.My BCG had to be stopped 4 weeks ago because it was burning my bladder and I was passing blood,bladder tissue and blood clots.I have regular urges to urinate which causes chronic right kidney pain and I often pee myself because I cannot reach the bathroom quickly enough.


 


 


 


This as you will see is a multi-layered question! ... in addition how do I get my love life back?

Expert:  DocPhilMD replied 3 years ago.
I'm really sorry you are having all of these problems

It sounds terrible.

Can I summarize the questions as I see them?

1)urinary incontinence?

2)burning bladder and cancer diagnosis and what to do next?

3)erectile dysfunction?
Customer: replied 3 years ago.

Dear Sir,


 


Thankyou for responding with such understanding.


 


1) Yes


 


2) Yes


 


3) My erections are as strong as ever but the pain at the point of orgasm/ejaculation prevents any pleasure and is incredibly frustrating.


 


After the first TURB no problems sexually ... after the second TURB about 2 years ago the problems started and despite being told everything would return to normal I have suffered ever since ... can this be resolved?


 


You have read my long introduction and trust you can deal with my concerns and give me some sort of long term prognosis?


 


My consultant is uncomfortable talking in detail and simply says 'well we saved your life' ... nothing further :) ...

Expert:  DocPhilMD replied 3 years ago.
You're welcome

I can understand how incredibly frustrating this must be for you.

To lose your marriage through no fault of your own must be remarkably traumatic

Have you tried any medicines for any of this? If so, what have you tried?
Customer: replied 3 years ago.

I have been given Cialis ... what a joke ... I have regular strong erections! ... so is not needed.


 


I have been given Oxybutynin for bladder spasms and that doesn't work.


 


I am a F.R.I.C.S. and cannot work at the moment and feel my world is crashing around me ...


 


Are medications available to fix whatever was damaged?

Expert:  DocPhilMD replied 3 years ago.
I think I have an idea.

If we assume that this is a chronic pain syndrome, then let's consider the best medicine I know of for chronic pain

Cymbalta

This medication is traditionally an anti depressant but is absolutely terrific for chronic pain

I think it might work to help your pain issues. Especially with sexual activity

I know this sounds strange but I do think it might help