If you have a psa over 20, there is a high probability of lymph node involvement. The higher the psa the higher the probability. I posted alot on this subject last Feb, but we have many new members and this information may be useful.
The current tests for lymphnode PC are CT scans and prostiscint. CT scans are totally unreliable and can pick up only the largest cancers, 10mm or greater. Prostascint does a better job, but is only 70% accurate and has a lot of false positives. The gold standard, which is a lymphadectemy, surgical removel of the nodes, is only 50% effective according to recent studies in Germany and Holland, especially if there is seminal vessel invasion.
The Combidex MRI is 96% effective in picking up small lymph node cancers. It is only done in Holland and cost about $2500.
The advantage in identifing lymph node PC is that they can be targeted for individual radiation or surgical removal in adddition to HT.
I had the Combidex procedure in Feburary and it was a painless two day process, the 1st day having nano particles injected and the 2nd day having an MRI. I recieved 1525 MRI pictures of my lymphatic system and prostate, valuable information in choosing a treatment.
On a whim, I submitted it to my insurance and they paid 100% without a question; pleasent surprise.
If anyone need more information, contact me.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.
2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path 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. G 4+3 approx 2.5cm diameter.
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.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.
Scheduled for 5 weeks IMRT in July