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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.
I was told the same thing 2 years ago after diagnosis. two years later (i month ago) had second bone scan. cancer is every where, except my arms. INSIST!
Jennie,
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.
