Health hotline: Prostate cancer Q&A

This month, the Deseret News/Intermountain Hotline introduces an online component. Besides calling in to ask questions about prostate cancer of Dr. Jay Bishoff and Dr. Scott Chidester, urologists at the Intermountain Urological Institute at Intermountain Medical Center in Murray, readers also submitted questions by e-mail. Here, Chidester tackles the most common questions asked.

Most of the e-mails centered around two complications related to prostate cancer treatment, erectile dysfunction and urinary incontinence. Some of the questions are presented here, edited to remove personal, potentially identifiable information.

The hotline, now in its 13th year, tackles a different health topic the second Saturday of each month. Readers can phone in questions directly to the specialists during hotline hours.

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Question:

Does "leaking" of urine during the night indicate any possibility of an enlarged prostate and/or prostate cancer?

Answer:

Leaking urine at night is not generally a symptom of prostate cancer, unless it indicates that the person is not emptying his bladder. Most of the time, prostate cancer causes no symptoms until it has spread. It is important for anyone who is having symptoms to see a doctor and get checked with a prostate-specific antigen (PSA) blood test and a rectal exam.

Questions about Lupron use:

With a PSA of 6.5 two years ago and diagnosis of "stage 3-4 cancer" I had my prostate removed surgically and the resultant test three months later was 0.03. My doctor prescribed a Lupron shot when PSA went to 0.07 a month later. After undergoing the effects of the shot, my PSA was at 0.3 one year after the shot. The current feeling of my physician is that I should undergo treatment with Avodart to hold the number down. My doctor does not want to refer me to an oncologist at this stage of my treatment and has stated the chances of a cure with radiation are 50 percent and chemotherapy should be saved as a last resort.

At what point would my PSA number indicate I should go to another form of therapy or doctor?

I am 78 and healthy. Nine years ago I had a prostatectomy. My PSA went very low and then within three months started to gradually rise. I then had Lupron and 38 sessions of radiation. My PSA went down to 0.