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John T
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Date Joined Nov 2008
Total Posts : 4269
   Posted 1/14/2009 2:25 PM (GMT -6)   
I finally got scheduled for the Combidex MRI lymph node imaging in Holland on Feb 13th and 14th. My oncologist feels there's about a 30% chance that I have lymph node involvement because of my high PSA even though my CT scan was clear.
For any of you that my be interested and are in the same position, Combidex MRI uses nano iron oxide particles and a powerful MRI to spot any PC that may have matastized into the lymph nodes. CT scans will only pick up large volume tumors and prosta scint is very inaccurate giving a lot of false positives. Combidex is said to be 96% effective in picking up PC in the lymph nodes. The prodedure is not yet FDA approved.
Radboud University Medical Center in Nijmegen NL is the only place in the world doing the Combidex MRI. Dr Barantz in the radiology department runs the program.
It's a two day program, 1st day the dye is injected then 24 hours later an MRI is run. The nano particles because of their shape can't enter infected lymph nodes and the MRI indicates these.
The cost of the prodedure is 1900 Euros (about $3,000 US) plus the travel costs. I'll keep you posted on how things turn out. There is about a 60 day waiting period for scheduling.
Diagnosed 10-08 at 63 with PSA of 33
PSA was 4.4 in 1999 and has risen steadily.
Had 13 biopsies and an endorectal MRI, all negative until 10-08. Two cores out of 25 with a gleason 6
2nd opinion with an oncologist said cancer found was insignificant, but suspected larger tumor somewhere.
Doppler ultrasound with target biopsy indicate a large tumor in the transition zone, gleason 7.
Bone and CT scans negative.
PSA3= 43; (high normal is 35)
Scheduled for Combidex MRI in Feb. (Lymph node imaging MRI done in Holland).
Location of tumor makes positive surgical margin unlikely.
Looking at IMRT with hormone therapy as soon as staging is complete with Combidex MRI.
Changed diet, eliminated all meat and dairy. Taking the normal supplements recommended for PC.

Regular Member

Date Joined Dec 2008
Total Posts : 194
   Posted 1/14/2009 2:58 PM (GMT -6)   
John T

I honestly hope you end up with a big fat "negative" and are forced into having a great little vacation over there. Best of luck to you.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Time to heal now.

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 1/14/2009 4:03 PM (GMT -6)   
That's pretty interesting and I hope that scan shows that the nodes are free. Please keep us updated on any info you get while there. Best of luck,
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 1/14/2009 5:47 PM (GMT -6)   
Knowing about lymphnodes prior to treatments, especially surgery is a wise move, this method might(probably is) be the best non-invasive choice there is today. It is always the FDA holding up treatments here in the USA, that people want choices on...I am suspicious of FDA agendas and even lobbying groups to protect the older status quo docs/treatments etc. (we are not an altruistic society, might have started out that way ages ago, today money, lobbist and other outside 'junk' is another thing we have to fight). Dr. Mark Moyad an expert on nutrional, supplements, foods and their therapeutic values, exposed some of the agendas of FDA at seminars and probably in his books. Why don't we have HIFU here now, I doubt it is unsafe, people on have done this and looks promising from what I remembered on that. Then other things approved by FDA have been shown to be....rushed..and what where you thinking???

Best to you John it is a smart move if one can afford such of course, or someone can pay for it.


Also, an option we do have here, not used alot is 'lymphendectomy' (or such terminology), surgerical sampling of selected nodes for biopsies to see if PCa exists. I looked into that back in 2002 and maybe should have done it, it did have some risks to consider, that are alittle more than little tiny side effects, plus my stats were so omnious that partin tables had me destined for failure on surgery.

John will have to fill us in on the whole experience and information on this choice, hope it gets over here soon where we should have it. People can make better decisions on PCa if they have a heads up on all the parameters and proper staging .

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