My husband has a j-pouch. He has had it for about 15 years and has not had too many problems. About 4 years ago he had some problem and had to have a resection and he had about 18 inches of the small bowel removed. Now he has been diagnosed with Prostate Cancer.

We have seen a surgeon and a radiologist and both say that because of the way the j-pouch is sitting and the scar tissue from his previous surgeries he cannot have surgery or radiation to treat get rid of the prostate.

He is only 56 years old. He has a lot to live for. I don't know where to turn. We have an appointment with another surgeon for late in September but I am worried.

His cancer is 7 on the Gleason scale. His PSA was 6.91. They don't think the cancer has spread, yet, but without treatment it will spread.

He does not want to do the hormone treatments because of the side effects.

Any suggestions would be welcomed.

I am so sorry for this news. You both must be devastated.

Get a second opinion. At this age, he is too young to skip treatment. If he was in his 70s or 80s, it may be appropriate to have that view.

With a Gleason score of 7, he needs to get into treatment ASAP. Hormone treatments may be a good option to begin while he figures out what is the best option long term. Yes, the side effects are no fun. He will have hot flashes and suppressed libido. But the point is to attempt to halt or suppress the tumor growth now. I would be much more afraid of the side effects of the cancer than the side effects of hormone treatment.

As a life saving option, he may want to consider surgery or radiation treatment that might risk the loss of his j-pouch. You might think of it in the way that all of us with j-pouches may require ileostomy in our future, depending on what happens during our lives. Of course, he would need to find a urologist willing to take this on. You probably would also want his colo-rectal surgeon to scrub in or at least be on stand-by, in case he needs to do pouch repair or ileostomy.

Bottom line- risk vs. benefit. What can he gain from each treatment option.

Jan

I am so sorry for your situation. I cannot speak to whether or not he should have surgery, but wanted to offer you some hope if he is able to...My father was dx with prostate cancer at age 52. He had surgery and 6 weeks of radiation. That was in 1993 and today he has had no sign of the cancer returning.

I hope they can find a treatment that will work as well for your husband if the traditional surgery/radiation combo truly isn't an option.

Thank you all for your kind words. We are still exploring options. I am not about to give up. He has been a part of my life for 36 years, he doesn't get to leave me that easily!

Concur with Jan...get a 2nd opinion regarding the ability to operate or not. I'm a 57 yr old male who had prostate cancer in 2005....Gleason score of 6. Elected to have surgery. No radiation treatment. No complications since. I am now scheduled for a J-Pouch. Correct, the location and scars are pretty much identical locations with the two procedures. Based upon my understanding,the prostate surgery is definitely the more delicate between the two. Whether or not the order in which one has these two procedures precludes one from having one procedure, but not the other....I'm not qualified to address. I can only tell you I'm having both, but my batting order was different than your husbands.

Although this is a very small study, there is a promising treatment for localized prostate cancer in patients with a j-pouch.

http://www.unboundmedicine.com/medline/ebm/record/18708...osis_Reconstruction_

Rick

Can you not get rid of the jpouch altogether and resort to an ileostomy.get rid of those 2 wannabes.if i had listened to my fathers original urologist he would not be here today instead we found a real dr, who did what was neccassary to save his life.I`m sure once the jpouch is gone cleaning up the adhesions shouldn`t pose a problem either.56 yrs old is much much too young to give up hope.Do what you have to to find that one dr who will notgive up on your beloved husband.he is out there I am possitive of this.God bless both of you and I pray that an answer to your problem will be found in short order.