has anyone had a proscinicty scan

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deer hunter
Regular Member


Date Joined Jan 2010
Total Posts : 250
   Posted 8/6/2010 8:01 PM (GMT -6)   
just thinking if anyone has ever had one of these scans and their  results  
dx age 57 01/06 open RP 4/06 psa in 01/06 8.1  surgery path report Gleason 3+4=7 poorly differentiated  tumor was 90%involved in both lobes surgical margins postive. in the right apex and right radial margins tumor grade G3  perineural invasion present high grade of PIN found  T2c NX MX PSA 0706  .01 10/06 .02 01/07 .03 04/07 .04  06/07 .05  07/07 .08 07/07 bone scans pelvic ct neg. 08/07 proscintic scan neg.9/07 psa.10 net with rad onc. wanted to do SRT but i did not do it 10/07  saw a new dr at Emory University [my old dr urg. suggested second opinion ]  bone scans negs ct scans pelvics neg. biopies of the bladder and adrinal glands neg.another proscintic scan neg.12/07 Psa .11 clinial trial Emory injected with protons to try and find the cancer cells no luck 3/08 psa .17 06/08 psa .23 psa 09/08 psa .32 12/08 psa .39 3/09 psa .39 6/09 psa .43  meet with medical onc. he said  i might have waited to long to start SRT 7/09 psa .50  another bone scan ct scan all neg.MRI neg. meet rad. psa the last of 7/09was .55 onc. 7/09 started casdex 50mg 1 day for 30 days 2 shots of lupron started rad treament 10/09 40 treatments 75 gm 12 shots each time all aroud pelvic finished 12/09  psa .07 and psa 01/10.05 next dr visit 03/10 wait and see 3/10 psa.05 5/14/10  family doc done blood work at my request her lab psa .01  
6/17/10 saw rad.onc. having problems with hips and muscles {bone density test sch, 6/25/10 wait and see

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/6/2010 8:42 PM (GMT -6)   
I think you are referring to prostascint. It is a scan to determine lymphnode involvement on high psa postate cancer patients. It will only pick up a lymphnode that has a 10mm tumor, which is very large and would generate a psa of probably over 100. So if you don't have a high psa it is a very innacurrate test and has a high rate of false positives.
JT

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.

JohnT


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/6/2010 8:56 PM (GMT -6)   
Prostascint can be used to identify spread to nodes or other areas as well. It is relatively inexpensive, but like John says, it can be ineffective at times. Here is a good write up on it:

www.prostate-cancer.org/education/staging/pscint.html

Basically you can't take the results to the bank. It's just a wee bit more information in a newly diagnosed patient. The original intent of the Prostascint was to help determine eligibility of patients for RP or RT. However, as we are seeing in other studies and reports, a lymph node involved or a spread to seminal vesicles does not necessarily eliminate effective therapy using either option. We have found that when a regional lymph node is involved, it is still possible to treat with curative intent with a local therapy in combination with another type of therapy. When this is considered, Prostascint has even less value.

That stated, if a person wanted to have one, and they understand that the information might not be entirely helpful, it can still be used to bolster information gathered in a TRUS and setting staging...

It can also be used to identify distant mets.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/7/2010 6:22 AM (GMT -6)   
Why even bother with a false positive possibly and waste money and time? But that is my thoughts on it. The other is the whole issue of scans in the USA..not definitive enough is the whole problem, you can have micro mets or undetected PCa cells, it might take maybe a billion cells to show up on scans(whatever the number is), lesser amounts won't be picked up or imaged. This explains alot of recurrance issues that were original told/sold as clear scans. Some docs will admit to how imperfect the scans are, many will not and lead you to believe that clear scans=no cancer....means no cancer detected with this imperfect machine...you could have cancer and some do and it is never detected, until possibly later when it has grown enough to show up. Are we marketed to on scannings, drugs, protocols, choices?? (well think about it for a few years)

Micro Mets mentioned by Dr. Barken a few years back, Dr. Strum mentions the less than accuracy of scans and wasted money on low stats patients whom about never would have a positive scan. Then scans can actually attribute to future damage, mulitple scans can be even worse if you read about it all...some claims of causing new cancers even maybe going on down the road. Just recently 2 people have died related to getting scans...but I believe it was because they had scans to the brain and maybe got to much radiation...it was posted at hrpca groups just recently with links...there is now a submitted push to maybe start regulating scanning, maybe as to doseages or disclosures, risks etc. You can google and read about scanning risks of radiation...worse than I suspected or thought. My scans were clear with alot of PCa volume 12/12 biopsies all 75-95%, high Gleasons 7,8,9's , and psa of 46.6....sounded nice to hear clear...my uro-doc had no expression on his face when I gleefully mentioned clear scans and never commented. (I later found out why, didn't know back then...thought scans were definitive that is why we pay tons of money for them). NOT!

If you don't believe our scans are lacking...ask John T...has a proven case of missed findings on scanning methods, until finding a superior scanning method outside the USA. Which Dr. Strum has mentioned and written about as being superior scan accessible to us...no it is not total perfection either. (currently new contrast agent is in the works to get Combidex back into useage, used for years prior). So knowing this one needs to consider what, where, how useful is this, whom is benefiting more on my scans?
Youth is wasted on the Young-(W.C. Fields)

deer hunter
Regular Member


Date Joined Jan 2010
Total Posts : 250
   Posted 8/7/2010 7:24 PM (GMT -6)   
thanks Tony.JT zufus. I truley belive PRostascint scans are a waste of money and time .I think micro metatasic is all to hard to find and by the time it is detectiable curtive treatment is diffcult.
dx age 57 01/06 open RP 4/06 psa in 01/06 8.1  surgery path report Gleason 3+4=7 poorly differentiated  tumor was 90%involved in both lobes surgical margins postive. in the right apex and right radial margins tumor grade G3  perineural invasion present high grade of PIN found  T2c NX MX PSA 0706  .01 10/06 .02 01/07 .03 04/07 .04  06/07 .05  07/07 .08 07/07 bone scans pelvic ct neg. 08/07 proscintic scan neg.9/07 psa.10 net with rad onc. wanted to do SRT but i did not do it 10/07  saw a new dr at Emory University [my old dr urg. suggested second opinion ]  bone scans negs ct scans pelvics neg. biopies of the bladder and adrinal glands neg.another proscintic scan neg.12/07 Psa .11 clinial trial Emory injected with protons to try and find the cancer cells no luck 3/08 psa .17 06/08 psa .23 psa 09/08 psa .32 12/08 psa .39 3/09 psa .39 6/09 psa .43  meet with medical onc. he said  i might have waited to long to start SRT 7/09 psa .50  another bone scan ct scan all neg.MRI neg. meet rad. psa the last of 7/09was .55 onc. 7/09 started casdex 50mg 1 day for 30 days 2 shots of lupron started rad treament 10/09 40 treatments 75 gm 12 shots each time all aroud pelvic finished 12/09  psa .07 and psa 01/10.05 next dr visit 03/10 wait and see 3/10 psa.05 5/14/10  family doc done blood work at my request her lab psa .01  
6/17/10 saw rad.onc. having problems with hips and muscles {bone density test sch, 6/25/10 wait and see

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/7/2010 7:53 PM (GMT -6)   
Deer hunter if you are having bone density issues which can happen on LHRH (Lupron etc.), you can either try to supplement it with fosamax, zometa, maybe some D3 vitamins maybe this range(6000-8000 units or more, test is called OH25 to monitor the level),cheap way to help.
Or drop the Lupron before you have 'skeletal' events which can happen on some drug therapies, and switch to alternative drugs that do not rob bone density. If density is an issue then zometa - zolendronic acid is used, especially used in late disease patients maybe also that have done chemo therapies. Expensive and I.V. given in 15 minutes or longer intervals, longer is better for less pain going in, fyi. One drawback is possible jaw necrosis, so while helping your bones in strenght, can cause that weird scenario in some patients, you could quit if that happens at all.

Drugs that do not have bone issues and have supposedly bone benefits possible: estrogenics class: estradiol either patches or gel, DES (man made estrogen 1-mg will work, compounded and mega cheap..no patents), or emcyt another in this mix (oral drug). These drugs also can work when Lupron or casodex fail, as they work differently and written about that they work even on hrpca...How Long...varies alot.

I suggest you start looking outside the box with your choices, skeletal events you can read about...not a pleasant thing to think about. Just suggestions, find all possible options if you can and then decide what you want to do, rather than a particular doc, you can find other docs to endorse various options. Some are soup n_zi types and some are very pro-patients desires and wishes, regardless of money envolved. I have seen both types, guess whom got fired?

Dx-2002 bPsa 46.6 12/12 biopsies all 75-95% PCa, Gleasons found 7,8,9's (2 sets), scans appearing clear (not accurate enough to actually know), ADT3 neo-adj., radiations after neutron & photon, ADT3 cont'd, quit drug after total of 2 yrs., started DES, off 1 year stabilized psa's, resumed still on it with results, feel great. Day and night difference from ADT!
Youth is wasted on the Young-(W.C. Fields)

deer hunter
Regular Member


Date Joined Jan 2010
Total Posts : 250
   Posted 8/11/2010 5:53 AM (GMT -6)   
Thanks for the information
DEERHUNTER
dx age 57 01/06 open RP 4/06 psa in 01/06 8.1  surgery path report Gleason 3+4=7 poorly differentiated  tumor was 90%involved in both lobes surgical margins postive. in the right apex and right radial margins tumor grade G3  perineural invasion present high grade of PIN found  T2c NX MX PSA 0706  .01 10/06 .02 01/07 .03 04/07 .04  06/07 .05  07/07 .08 07/07 bone scans pelvic ct neg. 08/07 proscintic scan neg.9/07 psa.10 net with rad onc. wanted to do SRT but i did not do it 10/07  saw a new dr at Emory University [my old dr urg. suggested second opinion ]  bone scans negs ct scans pelvics neg. biopies of the bladder and adrinal glands neg.another proscintic scan neg.12/07 Psa .11 clinial trial Emory injected with protons to try and find the cancer cells no luck 3/08 psa .17 06/08 psa .23 psa 09/08 psa .32 12/08 psa .39 3/09 psa .39 6/09 psa .43  meet with medical onc. he said  i might have waited to long to start SRT 7/09 psa .50  another bone scan ct scan all neg.MRI neg. meet rad. psa the last of 7/09was .55 onc. 7/09 started casdex 50mg 1 day for 30 days 2 shots of lupron started rad treament 10/09 40 treatments 75 gm 12 shots each time all aroud pelvic finished 12/09  psa .07 and psa 01/10.05 next dr visit 03/10 wait and see 3/10 psa.05 5/14/10  family doc done blood work at my request her lab psa .01  
6/17/10 saw rad.onc. having problems with hips and muscles {bone density test sch, 6/25/10 wait and see
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