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Q. How can swollen leg in prostate cancer patient be managed?

Answered by
Dr. Pratik Patil
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Aug 07, 2020 and last reviewed on: Sep 01, 2020

Hello doctor,

I am 68 years old, male. Height is 178 cm and weight is 71 kg.

Past Problem- Prostate Cancer Surgery last year. Current problem- Swelling in whole left leg and have too much pain. I cannot move leg. Post treatment- Hormone therapy maintenance doses of Firmagon (Degarelix) injection every 3 months. PSA- 0.01. Current situation- 3 weeks ago had swelling in left leg and doctors took out fluid from left knee. I had my Firmagon (Degarelix). Checked with local orthopedic, he told it is arthritis.

1. What is treatment of swollen leg? Doctors told me that there is no relation of Prostate cancer surgery with swollen leg.

2. Is it the effect of prostate cancer?

3. Is it the after-effect of Hormone therapy?

4. Why there is swelling 2 times in whole left leg within one month?

5. Can you suggest any medicine to reduce swelling in leg?

Following was my reports last year before prostate cancer surgery:-

1. PSA level was 24.

2. Gleason score is 9 (5+4).

3. DRE (digital rectal examination).

4. Conducted Ga68 PSMA scan and result is below:-

a. PSMA avid lymphnode is noted in left external pubic ramus.

b. Mildly PSMA avid sclerotic lesion is noted in left external iliac region.

c. Solitary mildly PSMA avid bony lesion is likely to be part of same disease process.

d. PSMA expressing prostate lesion(with extension and involvement) with lymphnodal.

e. Liver and spleen shows physiological tracer distribution.

f. Both lungs are unremarkable.

g. Urinary bladder shows of diverticulum in right posterolateral wall.

h. Gall bladder is visualized.

4. Metastatic Cancer spreads in bones.

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Hello,

Welcome to icliniq.com.

I am so sorry for the pain and issues you are facing.

1. Your treatment is spot on and is standard all over this world wherever you go so be sure on it.

2. Any hormonal therapy or medicine for prostate cancer would cause swelling all over the body or both legs or dependant parts of body like toes, soles, buttocks, back and not just only on one leg.

3. This is a repeated left leg swelling especially around the knees which is suggesting a local pathology/issue which can be either because of arthritis as rightly said by someone or this can be because of the external pubis Lymph nodes that are present on your PSMA scans which is unusual because PSA is normal so should not be causing issues for such a small lymph node.

It is mostly because of the arthritis issues which is an orthopedic issues and nothing to do with cancer. So please consult orthopedic and get treated. Medicines that will reduce pain would be tablet Naproxen 500 mg twice daily, tablet Dytor 10 mg once daily.


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