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My husband has always had a problem with his back. He had a bad motor racing accident 38 years ago. This last year it has re occured on a regular basis. He gets a terrible stabbing pain which he has always experienced, although the pain seems to have moved from the side of his spine to the bottom of his spine.
His diagnosis psa was 95.3 gleason 9 stage t3b. Zoladex reduced psa to .20 last reading 18th April 2010. He has been told that because his psa has remained the same that it isn't the prostate cancer and there is no need for a bone scan. I think he should be having another bone scan (last one 12 months ago) to make sure there is nothing going on. Or are the specialists correct. Is it the norm for the psa to always rise if the cancer has started growing elsewhere. I am so worried about him. He has been on Zoladex and cyproterone for 2 years. I would appreciate any replies.
I have almost the same situation, (PSA 76, Gl 9, T3b). I have had a pinched nerve in my back for 45 years that causes much pain at times. I was on hormones for 2 years and had a scan to start the PCa war. PSA is now 0.1, a rise from >0.01 for 2 years. Drs have not recommended any more scans. Most I have read says to wait until PSA rises more, but each case is different. Keep praying.
I still don't seem to have had my question answered. It there ALWAYS a rise in PSA when on ADT if there is metastasis. He is off to see his GP Tomorrow. Not sure what to do if his GP says he doesn't need another scan.
Your doctors know from experience that they don't normally see bone mets with a PSA below about 5 and typically 20.
However there are some cases where the cancer cells are so deformed (compared to normal cells) that they don't put out much PSA. In your husband's case the PSA seems to still be a good indicator of disease progression so that is the reason the doctors don't want to do the bone scan.
You might try to get a CT scan requested by a back specialist rather than the oncologists to see if there is some degeneration occuring. A bone density scan should also be done if it hasn't already. If they can't see any reason for the pain moving around then they will probably order a bone scan in the end.