Peyronies and Prostate Cancer

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isleofpalms

My husband has just been diagnosed with Stage 2 Prostate Cancer.  He has had Peyronies for a long time - give or take 5 years.  We are very concerned that he doesn't stand a chance of ever have an erect (even though curved) penis after having a radical prostitectomy.  We have just read about a new procedure called proton beam therapy.  It is only offered by a few hospitals in the United States mostly because of the cost.  Though it is FDA approved and Medicare will pay for it.  It makes sense to me to try to find a treatment and facility who deals with the cancer along with the Peyronies.  I think my husband feels that  having cancer along with Peyronies is like receiving a death sentence.  I'm trying to find information about the two conditions together and would welcome any assistance.

LWillisjr

I am really surprised his urologist hasn't recommended an implant. This would fix both conditions. It would create an erection and would help any straighten any curvature due to Peyronies Disease. You can do a Google search on the AMS 700 series. Several of the men on this forum have had an implant and are VERY happy with the results.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

funnyfarm

When you are in tune with the unknown, the known is peaceful.

Hawk

First, in my view your husband should consider what has the highest likelihood of saving his life.  To be blunt, dead men don't get erections either.  I think I am as well researched on the topic of prostate cancer as anyone outside of a Urologist, or and oncologist.  There are MANY things to consider.  I would pick what I thought was the best chance of a cure.  Then I would just assume I would end up with an implant in which case he will probably be much better off than he is now.  Even if he later faced reoccurring prostate cancer and needed additional radiation or hormone treatment, his erections would be as hard and longer lasting than any 18 year old.  

The satisfaction rate for that procedure is higher than almost any procedure on this forum.  The actual surgery only takes from 15 minutes to an hour and is usually done on an out patient basis.  I would likely start traction now however to maximize implant size unless he is the first man ever on this forum that thinks his penis is just a little to big.

Hawk
Here is a good source of info on PC Cancer Information, Support Groups, Message Boards - Cancer Forums
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

koss

Is there any connection between this kind of cancer and peyronee?

George999

I think different people would have different opinions on the connection between prostate cancer and Peyronie's, if any.  Personally, I think the connection is an upstream one.  I believe the same metabolic problem that precipitates one can also precipitate the other.  But with the underlying common metabolic problem (metabolic syndrome), there are no end of added factors that may destine one to be afflicted with both, or just one or the other.  For example, both Peyronie's and prostate cancer involve genetics.  A person can be strongly protected from prostate cancer by their genes, but vulnerable to Peyonie's, or the other way around.  In any case three things stand out to me:

1)  First of all, treatment.  Whether it is prostate cancer or Peyronie's or both, competent medical treatment by appropriate specialists is mandatory and is the number one first priority on this list.  Don't even think about the other steps until you deal with this one.

2)  Secondly, I would suggest looking at the metabolic syndrome side.  A lot of metabolic syndrome is undiagnosed and afflicts people who seem unlikely candidates.  Metabolic syndrome can afflict people who are skinny and people who have normal or even low fasting blood sugar and satisfactory A1C levels.  Anyone with either prostate cancer or Peyronie's or both very likely has a metabolic syndrome problem.  So managing refined carbs and eliminating all types of unhealthy "foods" is essential for best outcomes in the case of BOTH prostate cancer and Peyronie's.  I have found "You on a Diet" and "Blood Sugar Solution" to be extremely helpful in sorting all of this out.

3)  Thirdly, I would suggest getting Vitamin D levels up to optimal levels.  For me that would mean no less than around 40ng/ml.  Vitamin D is emerging as a powerful tool that can fix genetic abnormalities.  I just posted the abstract from a small pilot study which demonstrated health positive genetic changes in white blood cells as a result of Vitamin D supplementation.  I believe that changing genetics in other body tissues via Vitamin D probably takes years, since unlike white blood cells, they are not continually bathed in Vitamin D, so the process will be slower.  Nevertheless, I am convinced it is a worthwhile undertaking.  It is also not a do it yourself project.  It requires appropriate blood tests and precautions and needs to be done under direction of a qualified health professional.

- George

Hawk

Koss, as George stated, different people can have very different opinions.  I will give you a very different opinion that is shared by every prostate cancer specialist I have discussed this with.  

My short answer is that the only connection between prostate cancer and Peyronies Disease is that prostate cancer treatment can result in Peyronies Disease.

I do not think they have any other common element or underlying background or other connection.  The reason I think that is because even though I have read tens of thousands of posts and thousands of articles and studies on Peyronies Disease and at least that much on prostate cancer I have never even heard anyone that ever suggested there was a connection between the two in my life until George expressed his belief in a connection.  Keep in mind that I have consulted in depth with several world leaders in the treatment of prostate cancer in two prestigious hospitals. In addition I have consulted with several prostate cancer doctors is less well known hospitals.  

This is what I know:  Men that have been treated for prostate cancer have about a 16% chance of developing Peyronies Disease.  This is almost twice the rate as men without such treatment. These men also have about a 50% chance of having erectile dysfunction and in past years it was much closer to 100%.  The rate was not much better with radiation than it was with surgery.  It is just that ED took longer to set in after radiation treatment than it did after surgery.  There are no known increase of Peyronies amoung men that have prostate cancer before they have treatment, so it seems clear that it is the treatment that increases the chances of Peyronies Disease.

How is it that treatment causes Peyronies Disease?  The answer is likely three fold.
1. Prostate surgery is one of the most difficult surgeries on the body because as every surgeon will tell you, it is almost as if God never intended for a surgeon to be able to get to the prostate.  In open surgery the surgeon has to operate entirely by feel and not sight.  During the surgery the ureter is cut and and the section that is inside of the prostate is removed.  The remaining shorter sections have to be drawn together and reconnected.  This actually tugs on the penis and all by itself can cause some shortening.  In addition you have a catheter inserted while you are under anesthesia so often speed and efficiency is the goal, not gentle handling.

2. Since most men stop getting erections due to nerve removal or at least nerve trauma (all nerves responsible for arousal based erections adhere to the prostate almost like a net that is embedded in the surface.  The very absence of erections induces further atrophy and fibrosis.  This is very clearly documented is scores of studies and it happens regardless of the cause of the ED.  In addition to the chemistry changes associated with ED there is the increased risk of trauma due to sex with a penis that is far from being fully erect.  Interestingly diabetics have a very high incidence of ED as well.  

3. Finally, some of the treatment for ED such as penile injections can cause Peyronies Disease.  Even over-pumping to the extreme with a VED could cause Peyronies Disease in someone that is uninformed.  

So the connection between prostate cancer TREATMENT triggering or causing Peyronies Disease through direct and indirect means is clearly established.  The surprising thing is that Peyronies is not even higher for men treated for prostate cancer since ED is so much higher than it is in the general population of the same age.  In populations of men not having prostate cancer treatment (whether they have prostate cancer or not) the rate of Peyronies Disease climbs at a similar rate to ED which of course also increases with age.  With the use of Viagra in recent years many men with ED discover they have Peyronies Disease that would have never known it before drugs made it possible to get erections.  
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

George999

As I wrote at the beginning of my post: "I think different people would have different opinions on the connection between prostate cancer and Peyronie's, if any."  However flaky the rest of my post might be, it didn't take long for the first part to be validated, no doubt about that.

A lot depends on whether you are following the old school medical crowd or the new avant guarde docs.  I prefer the latter and strongly suspect they are on to something big which is why I am willing to bet my life on it.  Others will disagree.  Each one has to make his own decisions.  At this point there is no strong evidence one way or the other.  There are however some strong convictions on both sides along with some variations on how logic is applied.  The great thing with this forum, thanks to Hawk and the other pioneers he worked with, YOU have the opportunity to see all the views on any given subject, and see them discussed and critiqued openly and be empowered to make informed decisions based on those discussions and debates.  After years of hanging around here, I am still pretty amazed at what a powerful resource this forum is for Peyronie's patients.  I know of nothing else like it on earth.  - George

Old Man

Guys:  

After having prostate cancer surgery myself many years ago, the only connection that I see is what happens during the surgery. Insertion of the catheter in the OR prep room can and does cause damage to the penile tissue if not properly done. Rough handling of the penis in the OR can and will cause damage. I have counseled with several prostate surgery patients who experienced Peyronies Disease from their surgery.

Just my 2 cents in the mix of these dissertations.

Old Man  
Age 92. Peyronies Disease at age 24, Peyronies Disease after
stage four radical prostatectomy in 1995, Heart surgery 2004 with three bypasses/three stents.
Three more stents in 2016. Hiatal hernia surgery 2017 with 1/3 stomach reduction. Many other surgeries too.

Hawk

I think George and I have been in enough debates on this forum that he did not think I would let him just label all the doctors that would dismiss his premise as "old school".  He then of course labels those ( or maybe I should saw the one :) ) that agrees with that position as the advance guard.  It is kind of a well recognized propaganda trick.  "All experts agree with me."  Who are the experts? "Those that agree with me"

I agree with George on much but the evidence is on one side of this issue.  There are NO stats showing an increase of Peyronies Disease in men with untreated prostate cancer.  There are NO stats showing men with Peyronies Disease get prostate cancer at a higher rate.  The stats that show men get a higher rate of Peyronies Disease after treatment for prostate cancer are well established and well studied.  Further it varies by the form of treatment.  And finally we know that that lack of erection causes fibrosis.  There are no opinions here.  These are facts.  all that is left is to draw a conclusion.  You cannot look at those facts and conclude there is an an underlying relationship between Peyronies Disease and Prostate cancer.  If a statistical connection existed then obviously the statistics would quickly show it like just like they do for DC and Peyronies Disease, or Northern European decent and Peyronies Disease.  Furthermore I don't think you can find any university or research hospital on the cutting edge (advance guard) that would even suggest the possibility of such a relationship.  

Finally there is no equivalency in these positions any more than there is between the old guard like Dr. Lue and Dr. Levine and the "advance guard of "cure Peyronies Disease naturally" guy.  It is just not accurate to say "At this point there is no strong evidence one way or the other"  I have shown the evidence and can list hundreds  if not thousands of doctors that agree.  That is just non-existent on the other side.  In fact I don't even think there is another side of even 10 doctors on the entire earth that believe there is such a connection.

I hate confusing things this important in the minds of our thousands of readers.  Hopefully they can see the only evidence on this issue is on side.  

Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

George999

One factor, metabolic syndrome, increases the risk of BOTH Cancer and Peyronie's.  In the case of Prostate Cancer, while the increase in risk is not clear, the increase in tumor aggressiveness most certainly is, so there is a clear link.  Hawk, you can disagree with that if you like.  I challenge you to find anything that disproves it.  And my idea of avant guarde physicians are functional medicine MDs who deal with both cancer and Peyronie's AND metabolic syndrome, not specialists like Dr Lue who, while being avant guarde in the field of Peyronie's, is not a generalist who sees the bigger picture.  I also believe that only when better blood tests are deployed against metabolic syndrome, will we clearly see the link between ms and practically all non-infectious disease.  There is currently an unprecedented epidemic of dementia in this country as well and that too will eventually be clearly linked to metabolic syndrome.  The thing that is most responsible for killing people these days is Western diets laden with refined carbs and other toxic ingredients.  The even think that is not politically correct these days but it is gradually being proven to be the case and eventually most people will come around to seeing reality.  The ones that don't will die an early and expensive death and thus will also be a part of the solution.  - George

Quote

BJU Int. 2012 Aug 9. doi: 10.1111/j.1464-410X.2012.11406.x. [Epub ahead of print]
Metabolic syndrome increases the risk of aggressive prostate cancer detection.
Morote J, Ropero J, Planas J, Bastarós JM, Delgado G, Placer J, Celma A, de Torres IM, Carles J, Reventós J, Doll A.
Source

Departments of Urology Pathology Oncology Unitat de Recerca Biomédica, Vall d'Hebron Hospital and Research Institute, Universitat Autónoma de Barcelona, Barcelona, Spain.


Abstract

Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Metabolic syndrome can identify patients at high risk of cardiovascular disease. The prevalence of metabolic syndrome is increasing worldwide and is associated with increased age, obesity and hypogonadism. The association between metabolic syndrome and prostate cancer development has not been studied comprehensively, and published studies report divergent results. This study indicates that tumours detected in men with metabolic syndrome are more aggressive than those detected in men without this condition.


OBJECTIVE:

•  To further examine the association between metabolic syndrome (MS), prostate cancer (PC) detection risk and tumour aggressiveness.


PATIENTS AND METHODS:

•  From 2006 to 2010, 2408 men not receiving 5α-reductase inhibitors were scheduled for prostatic biopsy due to PSA above 4 ng/mL and/or abnormal digital rectal examination. •  MS was evaluated according to the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III definition. •  Tumour aggressiveness was evaluated through biopsy Gleason score, clinical stage and risk of biochemical recurrence after primary treatment.


RESULTS:

•  The rates of PC detection were 34.5% and 36.4% respectively in men with and without MS, P= 0.185. High grade PC rates (Gleason score 8-10) were 35.9% and 23.9% respectively, P < 0.001. The advanced disease rates (cT3-4 N0-1 M0-1) were 17% and 12.7% respectively, P= 0.841. •  The high risk PC rates (cT2c-4 or Gleason score 8-10 or PSA > 20) were 38.5% and 33.0% respectively, P= 0.581. •  Multivariate analysis confirmed that MS was not associated with the risk of PC detection but it was associated with an increased risk of high grade tumours (odds ratio 1.75, 95% CI 1.26-2.41), P < 0.001.


CONCLUSION:

•  MS seems not be associated with an increased risk of PC detection but it is associated with an increased risk of more aggressive tumours.

© 2012 BJU INTERNATIONAL.

PMID:
   22883053
   [PubMed - as supplied by publisher]



Quote

Article Defining the clinical characteristics of Peyronie's disease in young men. 2007

Deveci S, Hopps CV, O'Brien K, Parker M, Guhring P, Mulhall JP. · Department of Urology, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY, USA. · J Sex Med. · Pubmed #17081219 No free full text.

Abstract:

INTRODUCTION: Peyronie's disease (Peyronies Disease) is usually seen in men in their fifth decade of life. AIM: In this study, we investigated the characteristics of the disease in young men.

MAIN OUTCOME MEASURES: The demographics, clinical features, and associated comorbidities of the patients with Peyronies Disease were retrospectively reviewed.

METHODS: The findings were compared between men with the disease who were under 40 years of age with those over 40 years. Statistical analyses were conducted to define differentiating features between these two groups.

RESULTS: Of the 296 patients, 32 were under the age of 40 years and 264 over 40 years. The mean duration of the disease was 2 +/- 4 and 6 +/- 8 months in the respective age groups. Fifty-six percent of the patients under the age of 40 years and 75% of the patients over this age presented with curvature (P < 0.01). Thirty-seven percent under 40 years and 12% men over 40 years had more than one plaque at presentation (P < 0.01). Dupuytren's contracture was seen only in patients over 40 years of age. Pain at presentation was found in 75% under the age of 40 years and in 65% over 40 years (P = 0.03). Trauma history was found in 18% under 40 years and in 5% over this age (P < 0.01). Statistical significant differences were found between the groups under and over the age of 40 years for hypertension (P < 0.01) and dyslipidemia (P < 0.01). Diabetes was noted in 50% of the patients under the age of 40 years and in 18% of the patients over this age (P < 0.001). Multivariate analysis of conditions associated in men with Peyronies Disease under 40 years of age showed statistical significant differences for diabetes (P = 0.015), presentation within 6 months (P = 0.004), and having multiple plaques (P = 0.008).

CONCLUSIONS: Young men with Peyronies Disease are more likely to present at an earlier stage of the disease, to have diabetes, and to have more than one plaque at the time of presentation.


Hawk

George give it up on this one.  your own first long reference  that you quoted said
QuoteThe association between metabolic syndrome and prostate cancer development has not been studied comprehensively, and published studies report divergent results.
That means that it cannot show a connection between MS and Prostate Cancer Development mush less between prostate cancer and Peyronies Disease. You cannot win your argument by posting links that undermine it.

Then you pad with a second reference having NOTHING WHATSOEVER to even do with prostate cancer.  You seem to be grasping here.  Next you say I should prove your personal theory that counters all established medical and scientific data is not true.  Even though such a premise completely ass-backwards, I handily did that with the facts in my last post.

Are you now going to start contending that we accept everything we cannot disprove.  The shills and snake-oil sales men are going to love that approach.

Here is an phony example George: I used to have Peyronies Disease but I drank a Coke Cola 4 times a day and poured Mountain Due on my willy and it cured it.  "I discovered the carbonated fizzy stuff devolves plaque just like it does teeth." Now, prove that is not true!  You and most others on this forum know darn well that is not how science works.  If they don't then we have been a failure. You don't assume everything under the sun is true until you can disprove every false claim.  Prove you didn't kill 4 people!  You can't you say!  THEN GUILTY AS CHARGED!!!

You will likely now post some more evangelical non-evidence of the very same type warned against in the vitamin D link that you posted a couple days ago.  Then you will suggest your position is on a par with established science, but I will let readers decide.  I am done with this topic.  

Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

George999

Additional factors to consider regarding prostate cancer.

1)  Current research can only measure rates of DETECTED prostate cancer.  To assess ACTUAL rates would require autopsies on every study participant.  Many men die with prostate cancer that is never detected.

2)  Many men with metabolic syndrome are obese and the more obese a man is, the more difficult it is for a doctor to do a successful prostate exam.  Thus prostate cancer in obese and even overweight men is less likely to be detected than in the case of normal weight men.

3)  A similar situation holds true in the case of PSA.  The more overweight a man is, the less likely his PSA will shoot up radically as prostate cancer develops.  Thus metabolic syndrome masks cancer detection via PSA testing.  Again, detection via PSA tests is less likely with obese and overweight men.

4)  Many men with metabolic syndrome are taking Metformin.  Metformin, aside from reducing blood sugar and insulin levels, has other strong anti-cancer properties.  Thus men with metabolic syndrome who are on Metformin for life actually enjoy some degree of protection from prostate cancer that normal men do not.

The above three factors tend to skew the results of the research and mask the connection between metabolic syndrome and prostate cancer.

At this point you have seen the discussion on the subject.  Time to do your own thinking.

james1947

I am not sure that isleofpalms will understand the debate as she was last logged in 1 hour after registering at March 25.
The value of the debate is in having all this information concentrated. :)

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Hawk

I will just say I feel bad for her if she was looking for an answer which she obviously was.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

George999

I'm really not sure that this extended debate matters a whole lot to isleofpalms that much.  As far as I am concerned, what she needed to see most was:

Quote from: Hawk on March 24, 2013, 11:51:48 PM
First, in my view your husband should consider what has the highest likelihood of saving his life.  To be blunt, dead men don't get erections either.  I think I am as well researched on the topic of prostate cancer as anyone outside of a Urologist, or and oncologist.  There are MANY things to consider.  I would pick what I thought was the best chance of a cure.  Then I would just assume I would end up with an implant in which case he will probably be much better off than he is now.  Even if he later faced reoccurring prostate cancer and needed additional radiation or hormone treatment, his erections would be as hard and longer lasting than any 18 year old.

Here is a good source of info on PC Cancer Information, Support Groups, Message Boards - Cancer Forums


That is absolutely the number one most valuable piece of information in this whole thread for isleofpalms or anyone else in this situation.  It is VERY, VERY, wise advice.  It roughly translates to "when things are falling apart around you, think with your brain, not with your emotions."  People who think with their emotions in times of crisis, which is a hugely tempting route to pursue, end up with VERY poor outcomes and no end of regrets.  - George

inkhorn

I posted a question yesterday on this subject, and being new to the site, didn't know all this info exsisted. Thank you George and Hawk, I enjoyed the debate. While I see I have alot to research, my gut tells me I got Peyronies as a result of the radical prostate surgery. Regards Inkhorn

MarcPierre

The extensive information posted here is much appreciated to those searching for even a tiny shred of info on the subject. Thank you all.
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