Leg swelling and Prostate Cancer

igorvl · New User Joined: 03 Aug 2008 Posts: 6

My dad, 71, recently developed leg swelling, mostly top of the feet and ankles, on both legs.

He has his PSA grow from 10 to 23 over the last 11 years. He had 4 prostate biopsies (all negative), but we still suspect that he may have PC.

What tests are usually run to check if the leg swelling is caused by a metastatic PC ?

Replicant · Moderator Joined: 01 Nov 2006 Posts: 244

I'm not a doctor, just a reasonably well-informed layperson and patient.

The leg swelling sounds to this layperson like fluid retention.

When prostate cancer metastasizes, it usually goes to the bones first. I've never heard of fluid retention being an early sign of metastasis.

I could be wrong.

He should be seen by a good doctor--I'd suggest an internal medicine specialist--to investigate the fluid retention and get to the underlying cause.

Each successive negative biopsy reduces the odds that the patient has prostate cancer. That said, it sometimes takes a few before it's found (with me, it was biopsy #3).

But if negative biopsy #4 was recent, and he's not having bone pain, or urinary symptoms...I don't think I'd fret overly much about prostate cancer being the cause of his swollen ankles.

As for the PSA readings, does he have BPH (benign enlargement)? BPH is often a cause of elevated PSA, especially PSA that has risen gradually over the years, in men of his age.

I assume his digital rectal exams (DREs) were normal?

He could ask for a "free PSA" (that's the name, not the cost) test. fPSA can help the doctor discern between benign and cancerous causes of total PSA being elevated.

Best--
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com

igorvl · New User Joined: 03 Aug 2008 Posts: 6

I am afraid you may be wrong, and leg swelling is a very typical symptom of a metastatic PC. It happens when the tumor metastasizes into the bladder, at a place where urine is coming from the kidneys.

Replicant · Moderator Joined: 01 Nov 2006 Posts: 244

I stand corrected.
For example, I see this case report:
http://sciencelinks.jp/j-east/article/200410/000020041004A0314146.php
about edema and metastatic PCa.

I understand your concern. I hope you can get him to a center of excellence--in the U.S. these are National Cancer Institute (NCI) designated centers like Dana Farber, Memorial Sloan Kettering, MD Anderson, etc. I'm sure other countries (Royal Marsden in the UK?) have similar centers of excellence. The doctors at such a hospital should be able to tell you if his symptoms are cancer related. And I still suggest the fPSA assay.

Best wishes.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com

brainman

igorvl, I am very sorry about your father's cancer and swelling in his legs. Has he actually been diagnosed with bladder mets? I ask because swelling of the legs can be a sign of several other pretty dangerous things and I would hate for you to assume one thing based on statistical probabilities and it turn out to be some thing different.

Whatever the cause, the term "fluid retention" is appropriate if he is not passing enough urine. Is he urinating normally?

If I where you, I would have your father checked out soon by his own medical team. Keep us informed as to what you find.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

igorvl · New User Joined: 03 Aug 2008 Posts: 6

My dad will have CAT Scan of his abdomen and pelvis area.

brainman

Have you received the scan reports yet? If so, what did they show?
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

igorvl · New User Joined: 03 Aug 2008 Posts: 6

Yes, the report is back. They did not mention any enlarged limph nodes or mass in bludder. Prostate is very big (as always) and inhomogenious.
But on the small portion of lung that is visible in this scan they found 5mm nodular density, and because of that recommended a folloup in three to six months.

Beth56 · Regular Joined: 30 Mar 2008 Posts: 30 Location: California

Remember, there are two sides to the prostate. The ultrasound guided biopsy which is performed rectally can only reach one side, posterior side, or backside. In order to biopsy the other side, the anterior side, or frontal side, requires a surgical procedure. If cancer is suspected, you may want to discuss this with your father and his doctor.

Here is a short blurb about that:

http://www.ncbi.nlm.nih.gov/pubmed/18657203

But, I also thought this article was interesting regarding high PSA and no prostate cancer.

http://www.cancer.org/docroot/NWS/content/NWS_1_1x_High_PSA_Levels_but_No_Prostate_Cancer_Its_in_the_Genes.asp

I wish you well in your search for answers. Beth
_________________
I lost my mother to inoperable pancreatic cancer in 1990 after caring for her at home for 9 months.

And, my husband was diagnosed with prostate cancer in 2006. Gleason 3+4=7 PSA 3.2. Treatment of choice was proton beam therapy at Loma Linda Hospital, California. His current PSA is .52 and will continue to drop as the cancer cells die off.

	Cancer Forums Forum Index -> Prostate Cancer Forum	All times are GMT - 5 Hours
Page 1 of 1

A website for discussions about any type of cancer, including lung cancer, breast cancer, mesothelioma, prostate cancer, laryngeal cancer, leukemia, lymphoma, multiple myeloma and others