As a diagnostic any scan will be affected by HT as it immediately shrinks small tumors and makes them very difficult if not impossible to detect. It may still pick up very large masses that have not yet shrunk.
It is already confirmed that your BF has lympnode involvement. And with a Gleason 9 and a psa of 51 it is almost certain that surgical sampling of the lymphnodes and surgical removal of the prostate would not have cured him. A prostascint scan is inaccurate and now would be even more so that he is on HT. With those stats it was 99% certain that the PC was not contained and surgery would have been used as a debulking procedure only. I hope your BF was informed of this before his surgery. What did his CT scan and bone scan show before his surgery
If your BF does not already have a good prostate oncologist then I would suggest getting one of the top ones as it is well past the stage that any surgeon or urolgist can provide any meaningful help. I would also suggest "Beating Prostate Cancer, Hormone Therapy and Diet" by dr Charles Snuffy Myers as he also had PC than had spread to the lymphnodes.
Scans can be used to monitor progress, but only the Combidex will pick up small mets, PET scans should only be used if they are free and part of a clinical trial, because they have shown to be almost useless in detecting prostate cancer. You should also be aware that Combidex is no longer available as the imaging agent used is no longer in production. It is hopeful that in a year or two a new imaging agent can be found.
Good luck ,and at this point in time PSA and other blood tests may be a more accurrate way to monitor progress than any scans.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.