PSA 0.01 Positive Bone Scan

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Dave's Wife
New Member


Date Joined Feb 2008
Total Posts : 8
   Posted 4/30/2009 3:54 PM (GMT -6)   
We went for a bone scan and CT of abdomen/pelvis.  Abdomen/Pelvis fine - Bone scan showed skull, bilateral shoulders and thigh having areas that "lit up".  Then had x-rays, shoulders were degenerative arthritis; however skull and thigh "indeterminate" - then had MRI of thigh and CT of skull.  Thigh showed blastic lesion.  CT of skull - indeterminate.  My question - is it possible to have metastatic disease with a PSA of 0.01, we are getting conflicting thoughts.  Original PSA was well within normal range, yet Gleeson Stage 8 tumor with spread outside prostate.  Any thoughts would be appreciated.
Age: 53
DX: 12/07
Robotic Prostatectomy: NYC 2/1/08
Gleeson Stage 8
Perineural Spread
Seminal Vessicle Spread
Pre-Operations PSA:  2.68
8 out of 10 biopsies positive for tumor
Tumor: PT3A
Post Op PSA: 0.006


Roger G
Regular Member


Date Joined Apr 2008
Total Posts : 150
   Posted 4/30/2009 4:45 PM (GMT -6)   
Sorry I really don't have an answer for you on this one... I do have an 6 inch scare behind my right ear from an inderminate on my skull. After having a silver dollar or skull removed and biopsied, it turned out to free and clear of PCa. The urologist would not operate until I had this looked into.

Good luck.
Age: 44 (42 when diagnosed)
DRE Small Ridge on prostate, PSA 1.5
07/2007: Diagnosed cancer, T2c, Gleason 3+4=7
09/2007: Laparoscopic prostectomy @ Hamilton General, 4 hrs.
01/2008: Still working on ED.
 
 


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 4/30/2009 4:47 PM (GMT -6)   

Dave's Wife:

I've been dealing with a situation that is much like your husband's.  I had a follow up bone scan after surgery and it came back with 2 different palces that were considered consistent with metastasis.  That bone scan was done in September of 08 since then I have seen two very distinguished Prostate oncologists and they both say the same thing.  "I can guaruntee you that you don't have prostate cancer but I can't guaruntee you that you don't have cancer". My PSA is undetectable and has been since my surgery in June of 08.

There are a few types of prostate cancer that generate very little PSA but that should have been seen when the pathology was done after the surgery. Also if your husbands testosterone count is normal it is highly unlikely it is prostate cancer that is causing the problem.

The reason my doctor's havent done a biopsy on the places that "lit up" is they don't show as lesions on CT scans and its possible that the biopsy would miss the spot it needs to hit.

I have done a few other things like get a colonoscopy and had a dermatologist check me from head to foot for any type of skin cancer or such. 

Does your husbad have constant pain in any of the areas that lit up, if so that could be troubling.  Don't just concentrate on the prostate thing look everywhere.

Finally, ther are false positives that show on bone scans also but follow up CT's or MRI's should rule this out.

Good luck

David 

 

 


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 


Dave's Wife
New Member


Date Joined Feb 2008
Total Posts : 8
   Posted 4/30/2009 5:19 PM (GMT -6)   
David - thanks for the encouragement.  As stated, we had the bone scan, then plain film x-rays and then MRI for the thigh and CT for the skull and still they are all indeterminate.  We are having a testosterone drawn tomorrow morning to see if his is low and possibly giving a false undetectable PSA.  Will keep you posted.  Thanks again.

Age: 53
DX: 12/07
Robotic Prostatectomy: NYC 2/1/08
Gleeson Stage 8
Perineural Spread
Seminal Vessicle Spread
Pre-Operations PSA:  2.68
8 out of 10 biopsies positive for tumor
Tumor: PT3A
Post Op PSA: 0.006


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 4/30/2009 5:23 PM (GMT -6)   

Dave's Wife:

I was wondering about a few things:

Why the follow up bone scan and did your husband have a staging scan before the surgery, if so what did it show. Are these new areas of uptake?

Has your husband done any hormone therapy before or after the surgery, this could have some bearing on his PSA obviously.

David


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 4/30/2009 5:26 PM (GMT -6)   

Dave's Wife:

One last thing, I feel for both of you because I know exactly what you are going through.  Its almost worse in some respects because you're in limbo.

Hang Tough

David


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery


Dave's Wife
New Member


Date Joined Feb 2008
Total Posts : 8
   Posted 4/30/2009 6:03 PM (GMT -6)   

Yes, we had a staging bone scan prior to surgery and it showed the skull lesion and the shoulders with arthritis, but DID NOT show the thigh lesion.  The reason for the repeat study is that his father is dying now of prostate CA and he asked me to please take care of his son, I asked our PCP to repeat the studies just for "peace of mind".

Even though my husband spread outside the prostate, there was no hormone therapy or radiation therapy offered to us.

So, we have a new lesion not present one year ago, non-detected PSA (0.01)  with radiologist reading all studies/scans as metastatic disease, but Radiation physician saying "impossible".  We are not scheduled to see an oncologist, as per our PCP to get another opinion, but it is very frustrating to all of us.


Age: 53
DX: 12/07
Robotic Prostatectomy: NYC 2/1/08
Gleeson Stage 8
Perineural Spread
Seminal Vessicle Spread
Pre-Operations PSA:  2.68
8 out of 10 biopsies positive for tumor
Tumor: PT3A
Post Op PSA: 0.006


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 4/30/2009 6:12 PM (GMT -6)   
Remember to look elsewhere, I've actually accepted what the Onco's told me(it took a while) which has led me to look at other possibilities.  It really doesn't sound like prostate cancer is the cause of your husband's issue but stranger things have happened I suppose.
 
BTW the spot on my rib wasn't there on my staging scan so it sounds like your husband and I are bookends.
 
I'm actually having a complete new set of scans done next week, I'll let you know what turns up, hopefully nothing!!!!!
 
David 
 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery


Dave's Wife
New Member


Date Joined Feb 2008
Total Posts : 8
   Posted 4/30/2009 6:18 PM (GMT -6)   

Good luck with your repeat scans, you and my husband are like book ends in a lot of ways - he is also 54, had the Da Vinci procedure, etc. 

Again, thanks for the words of encouragement and best of luck next week, keep me posted.

Gayle


Age: 53
DX: 12/07
Robotic Prostatectomy: NYC 2/1/08
Gleeson Stage 8
Perineural Spread
Seminal Vessicle Spread
Pre-Operations PSA:  2.68
8 out of 10 biopsies positive for tumor
Tumor: PT3A
Post Op PSA: 0.006


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 4/30/2009 7:36 PM (GMT -6)   
Wow. I don't really have any words of wisdom, but I just wanted to send you a note and let you know that I will be thinking of you guys and following your thread. What an frustrating and scary experience and I know the scans can light up for arthritis type disease too that they sometimes are unable to determine. I will be hoping for the best and pray it turns out to be ok. It sounds very surprising that PC could spread so quickly with an undetectable PSA that was not HT induced. However, your husband's pre-op PSA was extremely low for the amount of PC he had too. I'm assuming that your PCP has run every other blood test that he/she could run right?!
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Dave's Wife
New Member


Date Joined Feb 2008
Total Posts : 8
   Posted 4/30/2009 7:41 PM (GMT -6)   
Thanks for your support, yes we have run all types of blood tests, etc, I am having two more radiologists look at the images tomorrow at work (I work for a large medical group) and then on Monday we will go to the oncologist and get his opinion and then May 12 we will go back to NYC to see the surgeon for any possible opinion he may have.  Just hope we can get good news from all involved.
Age: 53
DX: 12/07
Robotic Prostatectomy: NYC 2/1/08
Gleeson Stage 8
Perineural Spread
Seminal Vessicle Spread
Pre-Operations PSA:  2.68
8 out of 10 biopsies positive for tumor
Tumor: PT3A
Post Op PSA: 0.006


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 4/30/2009 7:56 PM (GMT -6)   
Did the post op pathology report show clear margins?
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum

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