How to manage swollen legs after prostate cancer surgery?

Question

Hello doctor,

I am 68 years old, male. Height is 5.84 feet, and weight is 156 pounds.

Past Problem - Prostate cancer surgery last year.

Current problem - Swelling in the whole left leg and too much pain. I cannot move my leg.

Post treatment - Hormone therapy maintenance doses of Firmagon (Degarelix) injection every 3 months. PSA- 0.01. Current situation- 3 weeks ago, I had swelling in my left leg, and doctors took out fluid from my left knee. I had my Firmagon (Degarelix). Checked with the local orthopedic, he said it is arthritis.

1. What is the treatment of a swollen leg? Doctors told me that there is no relation between prostate cancer surgery and swollen legs.

2. Is it the effect of prostate cancer?

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

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

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

Following was my report 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 the result is below:-

a. PSMA avid lymph node is noted in the left external pubic ramus.

b. A mildly PSMA-avid sclerotic lesion is noted in the left external iliac region.

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

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

e. Liver and spleen show physiological tracer distribution.

f. Both lungs are unremarkable.

g. Urinary bladder shows a diverticulum in the right posterolateral wall.

h. Gall bladder is visualized.

5. Metastatic Cancer spreads to the bones.

Please help.

Thank you.

Answer 1

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 of it.

2. Any hormonal therapy or medicine for prostate cancer would cause swelling all over the body or both legs or dependent parts of the 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 are orthopedic issues and have nothing to do with cancer. So please consult an orthopedic doctor and get treated. Medicines that will reduce pain would be tablet Naproxen 500 mg twice daily, tablet Dytor 10 mg once daily.

I hope this information will help you.

Kindly follow up if you have more concerns.

Thank you.