Posted 10/2/2013 5:43 AM (GMT -7)
Just looked up the chronology I keep
20130115 PSA 3.68, velocity 6 mos. Testosterone 293
20130124 review PSA with urologist
20130221 review biopsy with urologist - Gleason 9 (4+5), 7 of 12 cores, right PNI
20130306 Review biopsy with second surgeon
20130311 second opinion urologist ordered bone scan, CT pelvic scan
20130320 Blood Test Alkaline phos = 67, glucose= 86, BUN =17, Bun/Creat ratio= 19,
20130320 Results of CT Scan recommended bone scan that was already scheduled in 2 days
20130322 Bone scan confirmed bone mets but very vague wording, multiple thoracic vertebral bodies, right posterior ribs without a quantity
20130328 Lupron Depot 4-month shot administered by primary UR before I had met with 2nd opinion urologist or radio oncologist
20130401 second opinion urologist TRUS prostate size 50 cc, cysto normal, declared palliative
20130402 radio oncologist Dr. - declared palliative
20130405 applied to UF & Shands - personal research on Inspire.com and Healing Well.com after all urologists and oncologists relied on vague bone scan report and said palliative
20130411 radio oncologist - in response to Shands question on # of tumors, counted at most 5, one right sacroiliac, 2 thoracic vertebral bodies (spine) and 2 right posterior ribs, therefore Oloigometastasis
20130423 PSA down to 0.98 even after surge ,free PSA % = 22
20130426 Gainesville 1st consult w medical oncologist and admin director, Complete Blood Count, PSA =0.90
20130506 next meeting with primary urologist to review PSA, testosterone and discuss UF & Shands consult, claim they treat with curative not just palliative intent
20130513 DEXA Bone Density Scan normal
20130731 Second Bone scan showed "improvement" unquantified
20130801 Medicare eligible - 2nd 4-month Lupron treatment
20130808 2nd meeting w UF & Shands medical oncologist and admin director, 24 month ADT treatment plan
20130808 Primary UR follow up
20130812 Secondary UR follow up, recommended new radiation oncologist since prior had relocated, ordered CTC that showed zero, which is good.
201308xx New radiation oncologist ordered 2 MRI's
201308xx MRI to spine showed brightest bone scan spot at T7-T8 was benign herniated disc with spinal compression (unknown since no pain) but "mild metastasis at T4 & T9, but MRI to pelvis showed "classic prostate cancer metastatic to bone" in right sacral area that on bone scans appeared to just be a dot not symmetric to left sacral area.
20130823 first monthly Xgevas shot
20120926 second Xgeva shot
I don't think the time lapse was by design. Primary urologist was not going to order a CT Scan or bone scan since "he knew it would come back normal".
Whatever time the second opinion urologist required had already passed and he did not comment on amount needed.
You mentioned MRI in title but not in the text. I would recommend getting the MRI and bone scans plus CT Scan. Though MRI is not as good at identifying lesions, better clarity on ones it finds
Good luck and welcome to the club nobody wants to be in but which benefits those who are.
65 - DX 64 Feb 2013 PSA 3.68 (6 mo doubling) Gleason 9 (4+5)
T1CN0M1B stage IV w. 7 of 12 cores worst ones 70% right perineural Invasion PNI
oligometastatic 5 tumors 1 right sacroiliac, 2 thoracic vertebral bodies (spine), 2 right posterior ribs
1st Lupron 4 month 3-28-2013, 2nd Aug 1
PSA 3.68 down on 07-08-13 @ 0.2, T=24
UF & Shands treating w curative intent, not just palliative.