Is riding my bike indirectly killing me? (A very angry prostate seeking revenge)

Back story…

I’ve been riding for years. I was riding outside for probably a decade, road and MTB. Occasional fit bikes. I started really riding a lot after I retired. Like 90+ minutes a day almost everyday. Started on a Peloton, and progressing to a hysterically loud H2. But that aside, during the pandemic I rode A LOT. I developed saddle sores, I was riding so much. I joked to people that I was a lab rat, furiously riding to get my food pellets. I once rode over 5 hours. To ride over 2 wasn’t a fluke. I rode literally every day.

Then my PSA started creeping up.

I would stop for a week, and it would go back down. (The PSA measures a ‘pissed off prostate’, so mine was pissed off my riding)

I posted several time to the local bike club urging people that had spikes in their PSA to take a week off and get tested again. Yeah, the PSA went down for most of them. I thought I had ‘the secret’ to handling that part of my health.

I would change saddles, apparently not often enough, but donated a box of ‘seats’ that I had acquired over the years. Some only used for weeks. (You all probably know that song)

Then, over the past 2 years, my PSA spiked. It ended up just over 7. I took the week off, and it dropped to 6.9. Um, what happened?!?! I took another week and a half off and got a more advanced PSA test, and it dropped to 5.7. Not a big drop, but a drop none the less. But then it spiked again after a followup test. Something is wrong here, the dodge isn’t working anymore.

I was scheduled for an MRI, and the results were nothing short of stunning.

The urologist was shocked, and told me that I have one of the largest prostates he’s ever seen! He showed me their plastic models and said that mine was easily double their biggest one. (Go big or go home) He scheduled more advanced PSA testing, and came back with the idea that I had active prostate cancer. There are a few measurements of the degree of a mans prostate trying to kill them, and I was originally ruled a PIRAD 4 to 5. I was immediately scheduled for a biopsy, and the results were that out of 13 samples, three of them were positive for cancer, and at least one of them had the earmarks of creeping cancer on a nerve. (A ‘Gleason 8’, on a 1 to 10 scale: a potentially contained wild fire that wants out) The prostate doesn’t have a ‘capsule’ around it like many organs, so if anything wants out, there really is no ‘bag’ that keeps stuff in.

So here I sit with an enormous prostate with creeping cancer, and waiting for the bean counters to approve a PSMA PET scan, looking to see if any of that stuff is setting up house somewhere else in my body.

Years ago, I had been told there are 2 kinds of prostate cancer, and felt a great deal of comfort in it. There was the first kind: If you have it, you are likely dead before you know you have it. It’s like a 5 alarm fire and it spreads like crazy. People that have that have it everywhere quickly. (Oh, so that’s not a big deal because I’d already be dead, or gravely ill) The second kind quietly cooks in the darkness, usually popping up in ‘really old men’. Men usually over 70 to 80. I’m not even 65 yet!!

I read the book about steve jobs and his pancreatic cancer, and how he ignored it for years, and then tried holistic cures, until it was inescapable that he had it, and he was well on the way to dying of it. Now I’m waiting for STAT PET scans and STAT robotic prostatectomy surgery, and realizing how stupid and self deluded I was.

I hope I survive this. I hope I’m not forced to wear diapers for the rest of my life. I hope that creeping crud hasn’t crept to a place I won’t survive. The PET scan is head to mid calf. I won’t glow in the dark (I’m kinda of disappointed at that) but it should identify any wayward bits, and I’ll have to go through repeat PSA and PET scans every 6 months or so for the next 5 to 6 years.

All because I thought I had the tiger by the tail.

Thoughts, so far: Not doing anything. Yeah, my prostate wants to kill me, let it. The idea of wearing a diaper for the rest of my life is humiliating, but not everyone that gets the surgery ends up that way. I hate gambling because ‘gamblers always lose’, but the alternative is not really great.

So I wish I could go back and not be so sure I had ‘The Answer’. Two years ago, it likely wouldn’t be this bad. Three years ago it might be a 'Well, there are unusual bits in your samples, we should get it out, and then I would have a few more options. Who knows when it got gigantic.

I never thought riding a bike could piss my prostate off enough to make it want to kill me, but apparently it does.

Don’t ignore high PSA values. Get an MRI (instead of the rubber glove). It is a longish study, but it cuts the prostate into thin slices and shows every little thing. (The ‘rubber glove’ can’t touch the entire prostate, missing potentially all kinds of nastiness lurking just out of reach)

I hope I can survive this. I was stupid, and wow, this is not how I imagined I’d be spending the spring of 2024.

And all this time, I never knew my prostate was enlarged. Certainly not two to four times the usual large prostate. I missed an opportunity to address it earlier, for sure.

Here is an article relating BPH (benign prostate hypertrophy (your prostate is big)) and biking. Take it (more) seriously (then I did)…

EDIT: I mean, who didn’t know that biking a lot could cause ED (Erectile Dysfunction). I knew that many decades ago, but this? I feel strange feeling like I should have known more about this. Who failed? Me? The industry? Medicine? Lance Armstrong? Everyone, and no one?

Sorry if this is the wrong category, and hope it passes muster.

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So sorry this is happening to you. I had a 73 year old stop me on a trail. He was hiking. He used to be an avid biker and just wanted to talk biking a bit. He tried talking to me about biking and prostrate problems. I had never heard of this before he mentioned it. And now you. I was surprised it wasn’t more widely discussed in forums like this. Maybe I just missed it. Thanks for posting and all the best to you. Your attitude should help a lot.

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I was kind of taken aback too. Heck, when I told the wife, she asked if the BPH was from drinking beer! I never knew about BPH and biking, and BPH morphing into cancer? Um, really???

Sure the PSA does test for an angry prostate, but if it turns rogue and cancerous, potentially millions of men are walking around with a time bomb in their pants. YIKES!!!

Sorry to hear that. I dealt with BPH for a couple of years. Fortunately, my PSA has been normal. Had two treatments to reduce the size of my prostate and that’s been helping.

You mentioned nerve issues. Related but separately, there’s also a thread on Pudendal Neuralgia . I don’t know if this applies for you but sharing so you have it. I’ve been dealing with PN and that thread has helped me.

I’ve had a few people, couples sometimes, talk about ‘biking problems’, and it’s always been about two things: 1) Numbness and chaffing, and 2) ED. I’d casually toss out ‘Get a PSA done, but don’t freak out if it’s high’, thinking, again, that I had the right idea. I’d always tell people that it it doesn’t go down, or keeps going up, see a doctor. In my case, I never hit 9 or 10. I was stunned to hit 7, but to have it drop back again gave me a false sense of safety apparently. I should have taken it far more seriously. Well, or at least not blow it off as a ‘data error’…

But that’s ED, if they are talking ‘the limpy’ cyclists get. If you are experiencing nerve pain down there it could be pudendal neuralgia (literally nerve pain) . Neural praxia is what causes ED (literally nerve compression).

There is a lot of circuitry running through that area, and the prostate gets tossed around with the muscles at the top of the legs. Like they can see the psoas doing some of the types of prostate surgery, and I had angry really pissed off psoas muscles off and on for a few years.

I wish I had known that it was all causing my prostate to swll and throw a tantrum.

I’m sorry you have to go through this. Best wishes for your diagnosis and treatment. Thank you for sharing.

Sorry to hear that, stay strong. FWIW my dad didn’t ride bikes and he had prostate cancer, then a couple years later pancreatic cancer and 6 months later he was gone. Riding and ED? Thats what a friend (linesman) tries to tell me. I’m riding bikes and don’t have ED.

Stay strong.

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Sorry to hear about the diagnosis, but it sounds like you are getting excellent care. Assuming you proceed with the robotic-assisted radical prostatectomy, make sure you have it done by a surgeon with a lot of experience and does them regularly, preferablly multiple cases every week. Don’t be afraid to ask your surgeon about outcomes and whether their are prior patients you can talk to. If they are uncomfortable with this, its a sign you should find another surgeon.

Importantly, riding a bike does not cause prostate cancer or BPH. However it can raise your PSA and in some case can cause prostate inflammation. This is where seeing a knowledgable physician is important and can sort through the issues like OP did.

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I found quite a few articles and journal articles that said that biking can/does contribute to BPH.

contribute | kənˈtribyo͞ot |
verb [with object]
• (contribute to) [no object] help to cause or bring about: gases that contribute to global warming.

HOWEVER there is an oddity in prostate issues. Some ride for decades and never have a problem! Yes, some never have ‘numb junk’, some never have BPH, some never have a pissed of prostate that gets large. For those guys: I say I sure as hell wish I was you, I sure as hell wish I had your stoic prostate, I sure as heck wish I had your life. One more thing about BPH and prostate cancer is that you can have a father that had either or both, and never have it yourself. Conversely, you can have a father that had neither and you get either, or both. There isn’t a direct familial link to whether a son gets either. It’s weird, and yet my own board certified urologist said that biking probably contributed to my BPH, and the size of my prostate likely meant that I was doomed to have cancer in it.

I rode a hell of a lot. I had a fairly normal PSA until something like three or four years ago. Had I known the possible connection that biking had FOR SOME MEN to BPH, and that IN SOME MEN BPH can develop cancer, I would have bugged my doc more to get it looked at. I would have demanded that I be worked up for it.

What I said in the opening was not to claim that EVERY MAN WOULD GET BPH AND CANCER. The post is about MY story, and was meant to possibly warn others like me to take it seriously. And just because you, or others, don’t have issues does not mean others aren’t, or can’t.

Good grief, I posted MY STORY, MY SHOCK at what happened, is happening, and people with nothing better to do than slag me are coming out taking shots at it. Aren’t you supposed to be riding or something? Sorry, but not sorry. Good grief…

Sorry to hear about the diagnosis….the good news is that, if caught early, prostate cancer has a very high survival rate.

I have three very good friends (both riding buddies) dealing with this now……one was diagnosed 3 years ago and it had already spread to his bones. He is still doing well and was going to do Unbound with us until he tore his meniscus in both knees.

The other was a,so diagnosed with an aggressive form, but luckily it seems they caught it early and before it got out from the prostate. He just had it removed at the end of March and is waiting to go back in for more scans, but docs were positive about it.

The third has had high PSA levels for years and was always closely monitoring things, including biopsies. It finally came up positive and he had radiation treatment and is doing well.

So while it is easy to say there is a correlation between riding and prostate cancer, I don’t know if it is causal. The reality is that, if you live long enough, you will get it. The only question will be if you bother to treat it, and how. For many men, it is not worth treating since something else will likely take them out before the cancer will (since prostate cancer is often very slow growing).

This is a great reminder to get your PSA checked every damn year. It is not something to fool around with and it is so easy to do. Hell, they don’t even do the finger exam anymore, so there is no need to worry about that now.

Keep us updated on your progress. You got this. :facepunch:t2::facepunch:t2:

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Sorry to hear about your diagnosis. The only person I know who has had a prostate problem also about your age and also a keen cyclist , I think said it wasn’t cancerous after his operation and he was back to work within a few weeks and I think a month down the line he is back on his club ride. I can only draw parallel to my bowel cancer in my early 40s, that being in good shape makes things much smoother when bad things happen.

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My dad and both of my uncles have had prostate cancer. Fortunately my dad survived after surgery but my uncle wasn’t so lucky.
First off, cycling can elevate PSA, but all you need to do is not ride your bike before your test (say a week) to get a true baseline. You want to look for a rise in PSA in similar circumstances. Kind of like weighing yourself at the same time each day, cycling before a PSA test is like eating a big meal before weighing yourself then wondering if you have gained fat.
This also applies to other drugs, popular ones such as Finasteride/Dutasteride which will lower your PSA, you must make your GP aware of this as they need to apply a correction factor, otherwise you could hide an alarming rise in PSA through hair treatment.
Any rise in PSA needs to be monitored and preferably biopsied or mri. The younger you are the more important this is. Definitely start monitoring it when you turn 50, if you have family history maybe start younger. I’m planning on starting in my 40’s. My dad had radiotherapy and surgery level cancer at 54/55 so it probably started in his late 40’s.

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I had a lucky escape from a different cancer in my early 40s (it might have actually started before that, in my late 30s) I never had up till that time any family history. My then 80 y’o mother got it a year after me. Ive also read about a US cycling champ amongst others getting it fatally in their 20s. I’d urge anyone definitely not to put off testing on age grounds. I am not even 50 yet when testing for it officially starts in the UK.

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True, biking is not like a bullet to the head. It all depends on the prostate. In the beginning I was told that there are ‘irritable prostates’ that seem to react to things differently than other men. That was reinforced when I was able to prove that my PSA would drop after I quit riding. I feel that lured me into a false comfort with the whole thing.

Years ago I had a physician that made the connection with irritable prostates and the other symptoms of prostate issues and would ask me if I was having retention problems, weak stream, etc, and would not do a PSA based on that. My next doctor also skipped yearly PSA tests based on my not having ‘symptoms’. That was a mistake, apparently.

I feel like such a fool. But I had been told that it was ‘normal’ to yo-yo the PSA values. I don’t know how long this has been simmering. Likely easily the past three years. Yikes…

But all the symptoms of biking, numbness, pain, all of it, is not normal, and the reaction of an individual prostate can vary.

Five years ago, or so, I heard the story of a local cyclist who got his first PSA done and it was an 11! I think he was in his 60’s as well. I don’t imagine it went well, but I never heard anything more about them.

But I didn’t post this to say riding a bike will kill you. I tried to be tongue in cheek about it. Men (and women) need to realize that if their prostate is not happy, they need to keep an eye on that and deal with it on a timely basis.

Seeing ‘STAT’ on orders for tests before surgery is freaking me out. Hearing that it’s a campfire with flames 8 feet tall is freaking me out. Knowing that it’s spreading as I sit here, and that the biopsy process could increase that chance is freaking me out.

DON’T put yourself in that situation! GET TESTED! GET AN MRI! GET IT EVALUATED! You can’t lull yourself into a false sense of security because no one in your family has had prostate problems. You have options if you catch it early enough. GET A PSA TEST!!

And if you are under 50, but ride a lot, you might want to get tested too if for nothing more than getting a baseline.

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Oh yes, absolutely!

The hip replacement I had, was made so much easier because I was in really great shape. (Better than right now) They had me up walking right after that surgery, and I was doing laps around the hospital. After the pain of the first night, the ‘good stuff’ wore off, I was back on the bike by the end of that week. I literally bounced back from that. Even my surgeon was surprised how well I was doing. His staff were amazed too. I’m so grateful that I’ve had the time and drive to stay in shape. I read an article that said that after 60-something, men generally have only one great birthday, and YIKES, but I’m sure hoping that I can avoid the badness until I hit 85 and die in my sleep.

The nurses and registration people are sometimes so surprised that I’m not on ANY prescription medications. None. I’m sure Big Pharma hates people like me. I know people in their 40’s that take a cornucopia of pills and capsules on a daily basis. So I’ve been lucky, and I hope my luck holds out…

After seeing how much I ride, one doc asked why I was riding so much. ‘Because I want the grim reaper to have to work to catch me!!’ I hope it’s breaking a sweat! Maybe I’ve trained him to be faster. Hmm… :smile:

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Cancer Free! As my surgeon hugs me. Feels odd for some reason.

Most of the medical people point fingers at biking for the BPH I had, before it went bad. But whatever caused it, I had a gigantic prostate, staying surprisingly asymptomatic, and now added more scars on this body.

I’m grateful to the medical teams and the surgeon that carved that traitorous mass out of me. I hope to stay cancer free, for sure.

For men that fear the possibility, don’t. Fear the badness that comes if you ignore it. I should have been tested and that gigantic thing should have been identified before now, and I’m glad those hard working medical people didn’t let me ignore this any longer.

Get tested, get evaluated, get the surgery if needed. Avoid chemo, avoid it spreading, save yourself. /soapbox

But my surgeon told me that I was in ‘phenomenal shape’, and had no interstitial/internal fat that he saw during the procedure. He said that he’d rather have every person he operates on look like me on the inside. Even I was shocked. Be well, be healthy, be good to yourself…

I have another week off-bike, and then the process begins to recover come (most) of what I’ve lost during this process. Ride on!!

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One insane sounding side effect of this surgery is that the way it was done, digging through the bladder to get to the prostate (they used to go through the ‘back door’) is that the urethra is sewn together after getting it out of the prostate, and if I try riding before that heals, it could separate! If it separates, they would have to reopen me going through the bladder again, to find the urethra and sew it back together again. YIKES!! And that means another Foley catheter for 2 months (this time), until it has had a longer time to heal. (The bike seat pressure could cause it to separate, and even an erection could potentially cause it too. YIKES!!) Just the idea of having almost the same surgery all over again just to fix a plumbing issue is enough to keep me being a ‘good boy’ and not cheating. :flushed: :flushed: :flushed: I was freaked out enough over the possibility of dislocating my new hip after the replacement. Wow… Getting old, and getting ‘fixed’ comes with issues. Some BIG issues.

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Fantastic news….congrats!!!

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So circling around now nearly three months post-op.

Riding has gotten much better, more comfortable. (I use a ‘Depend Shield’ in my bibs, just in case, and it really helps to trim them shorter so I’m not sitting on the tail. I haven’t leaked on the bike much, but it has happened a few times. I live in some level of concern about a leak potentially ending up leaking in some part of the frame and causing a short. Although I guess sweat could so that too. I’ve found myself very much more concerned about leaks and potential smell to the point where it’s becoming a fixation. My wife keeps saying they happen, and I should be happy that I’m doing so well, but I guess accepting that possibility is something I’m not comfortable with. Maybe time will help me deal better with it)

Other issues: I was warned about the potential for a UTI, and boy that was hard. Peeing broken glass was sure shocking. Getting up during the night to pee has helped me to get back to sleep when I get to bed. That’s a bonus. About three weeks ago I also caught the new variant of Covid and after already feeling some hold over from the surgery, was taken down to the ground. I’m still feeling some possible symptoms from that so fighting gravity I guess. (Don’t get Covid. This time was worse than the earlier time. A total different mix of symptoms and a different recovery)

I’ve also heard from a wide bunch of men who have survived this surgery. One guy was the foreman for some yard work we had done. We kind of bonded evidently in our post-op-ness. He had a wider list of post-op complications so I’m feeling better about how I’ve been doing, but the not knowing is so unsettling. That’s why I’ve circled around to do this post. I could trust my surgeon, but he said I’d be ‘back to normal’ within 2 months, and that’s not at all true, but reading the internet and the experiences of other post-op patients and I’m glad it hasn’t been that bad, for me.

There are expected things, and there are common things, but this is about adapting to riding.

Take time… Use pads (Shields)… Change out of wet bibs soon after riding (I assume that’s what sparked my UTI)… Be creative? Be easy on yourself and recognize that as you age recovery is going to take longer. But don’t quit riding, and realize that there is life after all this.

It has helped to take a more active role in my recovery: removing the catheter myself was a treat! BE GONE!!! YEAH!!! But don’t get discouraged and:

Ride on…

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