Low back and hip pain, an interesting study

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Purgatory
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Date Joined Oct 2008
Total Posts : 25380
   Posted 5/30/2011 9:16 PM (GMT -6)   
While this link leads to an older Canadian study, the information is still good and informative.
 
 
My new medical oncologist is concerned about the amount of right hip pain that I have been experiencing for the past 6-7 months, that I never had before.  He's less impressed with conventional bone scans, including the one I had in February of this year.  He has ordered some conventional X-rays of both hips and lower back.  Said he can tell more from those, than from that of the bone scans.
 
In recent months, the pain has become deeper, and at times extends around my lower back.  It's become increasingly harder to stand upright unsupported for any length of time.
 
I thought there were some interesting points in the study, it's open for discussion.
 
David in SC

Northfoot
Regular Member


Date Joined Mar 2011
Total Posts : 81
   Posted 5/30/2011 9:30 PM (GMT -6)   
Purgatory,
I really hope that the published study you listed doesn't apply to you. I do not think the person's psa was noted. As you know, although metastasis can occur with any level of psa, it most likely occurs with a level higher than yours. Articles like that scare me, for who doesn't have back pain periodically when you reach your fifties or older? I hope your xrays only show degeneration consistent with osteoarthritis.
Prostate cancer chronology:
• 4/07 psa 2.54
• 10/07 psa 2.66
• Biopsy 12/24/07
• Diagnosis 1/4/08
• Surgery 1/22/08 G4+5
• Psa tests 2/08, 3/08, 6/08, 9/08, 12/08, 4/09, 7/09, 8/09, 10/09, 1/10, 4/10 all negative
• Psa 6/22/10 0.06
• Psa 7/10 0.05
• Psa 9/10 0.05
• Psa 11/10 0.06
• Psa 1/4/11 0.08
• Radiation started 1/19/11 and completed 3/15/11
Psa 3/29/11 0.05

Purgatory
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Date Joined Oct 2008
Total Posts : 25380
   Posted 5/30/2011 10:08 PM (GMT -6)   
The normal thinking is correct about PSA and mets, but there are still exceptions, including Sonny of our group here. My new doctor is at least concerned enough to want to investigate it more.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 5/31/2011 5:08 AM (GMT -6)   
Purg- did this doc already do these types of tests that might be of use, prior to jumping into a radiation X-ray method??? (Page 35 Dr. Strum's book): PAP, CGA, NSE, CEA, Pyrilinks-D (or other bone breakdown markers), chemistry panel evaluations of kidney, livver, bone and electrolyte status? Probably has done something amongest those. The big ones that could be used for possible mets is PAP (older test but not worthless) and Pryrilinks-D or similar type of testings (this usually is I think considered fairly definitive if you are shown with the positive risk analysis).

When you get the new X-rays, I know you had the old ones, so comparisions will be vital in seeing if any changes exist. As you know psa alone is a lousy marker of knowing the biology of PCa and what is actually going on, the wiser onco-docs know all that all to well and that is why they suggest all these other testings, that are simple lab tests to include in the whole concept of prognosis on the disease.  Hopefully yours is arthiritis and such.

Post Edited (zufus) : 5/31/2011 5:19:46 AM (GMT-6)


An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1148
   Posted 5/31/2011 6:22 AM (GMT -6)   
David,

I can completely understand you wanting to figure out why you have this hip pain. You have had so many issues one after the other and I imagine that the only way to deal with it looking at each problem systematically.

Since you have had this problem for 6-7 months the PSA 6-7 months ago (if I extrapolate backwards from 1.24 in February, with a doubling time of 6-8 weeks) would have been 0.3-0.6 range. Would it really be possible to feel a met at that kind of PSA?

I really hope that it is not possible, that with all the trauma of your recent surgery and the weight loss that you just simply are missing some vitamin or something easily fixable. I hope this is the case cause you just need a break.

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03|Feb11 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01|Feb11 – 0.01|Apr11 – 0.01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/31/2011 10:03 AM (GMT -6)   
zufus, there is no arthritis present in any of the pain zones, that has been established and verified with 3 bones scans in 3 years.

i will be discussing other tests with the new doc when i see him again in 3 weeks. i told him i would only be interested in future tests that had a ghost of a chance of proving anything new or definitive.

an, hard to say, that's why I am see the caliber of doctor that i am. hopefully there is an answer out there. remember sonny had a met post radiation with a psa only in the 1 to 2 range. so with my last psa at 3.84 and rising, all things are possible.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 5/31/2011 11:39 AM (GMT -6)   
I'm sorry to put a downer on all this, but, I've got mets to my right acetabulum and right hip, with increasing pain over the last two years and with PSAs of <.1 and <.2, no higher. I've been in bed and unable to walk without use of one of the tools from my growing medical arsenal which has increased from cane to walker to wheel chair since early March of this year when I underwent an emergency colostomy. I've been living on morphine, but latest plan is to wean me off the morphine and try to replace with methadone. (The mets all over my lungs have caused me no discomfort so far.)

I'm sorry David, but my situation is, apparently very unusual and I wouldn't read too much into it, were I you.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/31/2011 1:18 PM (GMT -6)   
Gordy, so glad to hear from you again, so sorry to hear of your present condition. I hope and pray that things can turn around for you so you can find some relief.. Just remember, there's a whole bunch of guys here rooting for you...
James C, 64, East TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Prob. microscopic inv.-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 5/31/2011 1:36 PM (GMT -6)   
Gordy thanks for joining in and we all need some support and friends in the battle. People need to know how bizzare PCa issues can become, thanks for being brave enough to post that for the sake of others to learn something on this, no doubt your case is unusual but not unheard of....not everyone would be willing discuss such or post it. Applaud your fight and willingness to jump onto the forum.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/31/2011 3:26 PM (GMT -6)   
Gordy, so sorry to hear of your extreme difficulties. I am in no ways trying to make a comparison between your PC journey and mine. I didn't quite get what you meant when you said "I am sorry to put a downer on all this"

I do not believe I have mets at this time, bone or otherwise. Neither does my uro nor even my new medical urologist. But the new doctor won't rule out the possibility of that at this point. Thus further tests and he wants to do coventional x-rays soon.

My journey has been an odd one too, doesn't look bad based on my original post surgery pathology, but has acted agressive and fast ever since. Having both quick recurrance from both surgery and SRT.

We are both ostomite's at this point. How are you adapting to your stoma? And is yours a temp, or the perm variety? Last September, I underwent major surgery for the Urostomy, as the result of faulty radiation destroying the functionalness of my bladder. If you ever want to disucss wafers and appliances, I am getting use to the lingo. My stoma ended up being a convex one instead of the normal concave, so its taken several months to get the right product. I can get one to last 7-8 days now.

I understand about the pain drugs. I have been on Loratabs since July of 2009 continuous (all under doctor's approval), with the exception of a short period (Nov/Dec 2010). My new oncologist has actually increased my doseages in order to get a better handle on pain control for me.

These hip pains, and now lower back, did not exist beyond 6 months ago, and they have been increasing. I have to walk with a cane at all times outside, and at times, should be using a walking, but my foolish pride has kept me from doing it so far.

I wish you all the best, my friend, and PC brother. You are traveling a very rough path, yet you are a fighter still. Please keep in touch with all of us here. We really do care. And we want to support you all we can.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 784
   Posted 6/1/2011 1:03 AM (GMT -6)   
Hi David, have you ruled out slipped disc etc? I am sorry to hear that you need a cane to walk, as I have had 3 major back operations, and the lumbar part of my spine is bolted together, I can sympathize with your infirmity , with everything that your body has been through, you may have done some damage to your hip and lower back maybe?

hoping all goes well.

Mal.
age 67 PSA 5.8 DRE firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept 07 Totally dry
PSA 23rd Oct.0.5
Started SRT on 5th Dec.
Finished 24 Feb 08
PSA from 30th April 08, until now range- 0.5 to 0.7

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/1/2011 9:00 AM (GMT -6)   
Mal, no evidence of any disc or specific back problems. This is new area to me.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/1/2011 9:20 AM (GMT -6)   
David- I don't seem to do anything the easy way. I awoke at about 3 AM on Saturday, March 5 shaking uncontrollably. As I passed in and out of consciousness, I kept refusing to let my wife call 911. Eventually, I fell out of bed and awoke in the emergency room of the local dinky hospital. The doc in the room with me told me my white blood count was 30,000 and asked if I wanted to be treated or just "made comfortable". I asked him if I was going to die and he replied "well, you're very sick...". I passed out again and my wife decided I wasn't ready to check out so they put me on anti-biotics for 3 days, at which point a surgeon showed up at bedside and explained that I had a tear in my colon, probably from radiation, which dumped fecal material into my abdominal cavity causing sepsis which caused pneumonia and that I needed an emergency colostomy. "In a day or two" I asked? "In an hour or two" he replied, else I would die. Afterward, the surgeon told me how incredulous he was that they would allow me to lay there for three days before calling in a surgeon.

The wound care nurse at the hospital was very good and got me started with Hollister products. Fortunately, my wife has been an angel of mercy as far as dealing with the wafers and bags. When I wake up in the middle of the night with a full bag, I just call her name and she jumps out of bed and starts doing her thing. The only part which takes some planning is dealing with the constipation from the morphine and then the small explosion when the bag finally fills up. At staple removing follow-up visit, the surgeon explained that the procedure could be reversed in 3 or 4 months if I wanted, but, of course, that would be major surgery all over again.

If it's not one thing, it's another.

-Les

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/1/2011 9:47 AM (GMT -6)   
Les, I really feel for you. My urostomy was a tough call, but after 11 full months of extreme bladder pain, bladder spasms by the hundreds, and no hope of healing, I made the decision. I spent 5 1/2 days in the hospital, and I won't lie, it was the most difficult recovery I have ever been through in my life. With mine, there was no hope of it being a temp. solution, I knew in advance it would be for life.

My wife is a nurse, so she is my angel. I know how to change my device if it ever failed when she is away, but she has it down to a science. She can change it out in 5 minutes or less, and as a rule, its just a once a week affair.

I am big on the Hollister brand, we tried them all. So we use a 2-piece Hollister Convex device. So far so good.

I wish you only the best, I know its a tough road.

David in SC

If you ever want to talk, just e-mail me your number.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/1/2011 5:37 PM (GMT -6)   
James C and zufus - Thanks for the kind words.
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