Prostate Cancer Survivors






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Re: Re: undetectable PSA and bone mets ?

Hello Bernie,
I readwith interest your posting.
My husband was diagnosed in may 08 with psa 93.5 gleason 9 and stage T3b. Bone scans have shown no mets. We were very relieved. I am amazed with such a high psa and gleason that it showed no mets. He was sent for an xray on his hip as the bone scan showed "something". The oncologist said that the xray was ok. I am very suspicious of these "wear and tear" spots on bone scans and xrays which is what they say are on my husband's shoulders and one hip His pelvic MRI scan showed spread to both seminal vesicles and into the borders of the gland. His urologist has said the scans cannot account for micro spread. He has been on zoladex for 6 months and his psa on the last blood test was .70 which is great. I am very worried that with such high initial results that these micro cells are lurking somewhere and waiting for the adt to fail. Was your gleason score and stage high at initial diagnosis. Where did you have the radiotherapy? They have told my husband that he is not a candidate for radiotherapy, only adt. How are you doing with your treatment? Is the treatment keeping everything under control. I do hope it is.
Best wishes

Re: Re: Re: undetectable PSA and bone mets ?

Hi Jennie,

My husband was 50 in June of 2007 when first diagnosed. His PSA was 19.8 and gleason of 4+3, Type IV. He was told that his cancer was VERY aggressive and not curative. We were looking into HIFU but had to ensure that the cancer had not spread outside the prostate (11% chance it could have). Well, the lymph node removal and biopsies confirmed that it had spread to the nodes. MRI and Bone scans showed clear back then. He was treated with a three tier approach. Casodex/LUPRON, then tomotherapy for 25 sessions and lastly, HDR. He developed severe hip pain a month after the HDR and a week before his second LUPRON shot. X-Ray showed nothing.
Now he has developed pain in his back and right heel. So severe that he lives on morphine and supplements it with vicodin. His last PSA was .67
Just had a bone scan done last week. Something was there but of course the tech could not comment. We are awaiting the results.
As others have mentioned, low PSA may not tell the true story for those with "aggressive" PC.
Life at 52 is just a constant drug high for Fred. Hopefully, this scan will give us some answers and therefore, some combative ways to fight this awful awful disease.

Re: undetectable PSA and bone mets ?


While I don't know the details of your husband's case, I couldn't disagree more that he is not a candidate for Radiation treatment.

From my point of view, that is only true when it has been confirmed that there is distant metastasis.

If there are known mets outside the pelvis, it doesn't matter what you do to the pelvic area. Elvis has left the building.

However, even with a high PSA and Gleason, if his bone scan and CT are clear, he may well benefit from whole pelvic IMRT.

Get another opinion.
Consult with a radiologic oncologist.

Tony - USA