MRI, bone scan, CT scan-- is it worth it?

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New Member

Date Joined Jun 2007
Total Posts : 2
   Posted 6/14/2007 3:00 PM (GMT -6)   
Thank you to everyone who responded yesterday-- this is really a wonderful support group, and I appreciate everyone's candor and kindness!
My father was recently diagnosed with prostate cancer.  He was wondering if anyone has had experience with an endorectal MRI with spectroscopy.  Is it worthwhile to do to determine the extent of the cancer and treatment options?  (he was told that because the cancer is microscopic, they will not be able to see it in the MRI).  Also, is a bone scan or CT scan worthwhile?
If you can share your experiences, would greatly appreciate it!
To tell you about my father, he is 63 years old, has a PSA of 5.8, a Gleason score of 6 (for small cores, a 7), and a small prostate because he was taking finasteride for many years.  He is planning to do either open or robotic surgery.
Thanks again!
a concerned daughter

Veteran Member

Date Joined Jul 2006
Total Posts : 686
   Posted 6/14/2007 5:14 PM (GMT -6)   

Hi "Concerned Daughter" ( I have two of those)

Your basic question about determining the spread (if any) of the cancer  is a very good one. I did not have a followup MRI, but I did have a series of scans and tests (both a bone scan and ct scan). They did not indicate spread and post op tests confirmed that.  The indignities of diagnosis.

The question comes down to peace of mind for you and your family and/or information for the doctor. It also comes down to who will pay for those tests.  If your insurance covers it completely and your doctor thinks it will help him, then advise your father to do it.

I had DaVinci Robotic surgery and so far things have gone ok.

Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
Back on the golf course...
90 day PSA  less than 0.01 (undetectable)

Regular Member

Date Joined Sep 2006
Total Posts : 211
   Posted 6/14/2007 6:26 PM (GMT -6)   
e MRI can sometimes detect penetration of the capsule, but the results are mostly not the clear cut picture often presented as examples.
It is very unusual for a bone scan to detect bone metastases when PSA is under 20, which is why many doctors will not suggest them for those instances.
The Diagnostic Center for disease Sarasota claims to have state of the art equipment and would have detailed information.
MSK have various nomograms which doctors and patients can use to assess risk. (For example that cancer might have spreas to lymph nodes.)
ProstaScint scan with CAT scan can detect a high % of lymph node involvement.

Regular Member

Date Joined Feb 2007
Total Posts : 242
   Posted 6/15/2007 5:30 PM (GMT -6)   
Hi concerened daughter. I have been in you shoes. My dad was 49 when he was diagnosised, and now my husband at age 47. When Kurt was diagnosised, my dad's old doctor found out. He is an onocologist. He called me and sat an appointment. Before seeing him, we saw 2 urologist, both who said other test were not needed, and we didnt need to see an onocologist. We went anyway. I trusted this guy and I wanted his opinion. First thing he did, besides reassuring us was schedule a full body bone scan and CT scan. He told us that he was currently treating a guy Kurts age who had his prostate removed and then discovered it had metastasized into the bone. He said if the guy would have had the test, then he wouldn't have gone through with the removal, and treatment options would have changed. It is rare with your dads numbers to find anything, but the piece of mind was a great relief for us. Kurt's CT scan found "too numerous to count enlarged lymph nodes" not felt to be related to PCa, but large enough to have the doctors watching. His 2nd CT showed no change, so maybe he was born that way. Good luck to your dad and yourself. A couple hours of tests, in our opinion, is very worth the piece of mind it gave us as well as our loved ones. Courtney
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Live in OK
Da Vinci scheduled 3-14-07 in Austin
Post-Op  Gleason 6, Stage t2c nx mx  YAAAAA HOOOOOO! 
1st PSA Post OP  Undetectable!!!!!!  OFF THE CHART
2nd CT scan, to recheck enlarged lymph nodes not related to PCa NO CHANGE relook in 6 months

Regular Member

Date Joined May 2007
Total Posts : 21
   Posted 6/15/2007 7:21 PM (GMT -6)   

Hello Concerned Daughter (I also have two concerned daughters),

I was diagnosed in April of this year with a very rare form of prostate cancer, a pure neuroendocrine carcinoid of the prostate. There are only a few other cases (less than 10) in the literature and they all had metastasized to the bone and other organs. Fortunately, mine was found very early and a bone scan, octreoscan (specifically for neuroendocrine cells), CT scan and a transrectal MRI all indicated that the tumor was localized to my prostate. Without these scans, I would be having a different form of treatment (radiation + chemo). However, I am now scheduled for a laproscopic radical prostatectomy next week because we know that it is confined to the prostate.

These scans give you the piece of mind of knowing that you are making the correct therapy choice.
I wish you and your did he best,
Age:50, Biopsied 4/9/07, 2 of 12 biopsies positive, pure neuroendocrine carcinoid tumor of the prostate, No gleason score, PSA normal 1.4, Grade:T2b, CT, Bone scan, and transrectal MRI all neg., confined to prostate, evaluating different treatment options. 

Regular Member

Date Joined Oct 2006
Total Posts : 444
   Posted 6/16/2007 10:20 PM (GMT -6)   
Dear Bob

I started a thread on this forum awhile ago asking members to comment on whether their doctors had ordered them to take a bone scan and an endorectal MRI--a great majority said no to either one or both of the tests which surprised me. It is known that the tests cannot be relied upon 100%, but they are far from useless tests. I personally think that it is better to have the tests than to ignore them. They are just another indicator thrown into the mix of all of the tests to approximate what stage of PCa you are at before treatment. I consulted with one of the top urologists at a top medical institution and he ordered both tests for me. The tests were not administered at the hospital and I have no reason to believe that the hospital had any direct financial interest in the tests. Good luck to your Dad!

68, 29-core biopsy 9/27/06, PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area],  Gleason 6 [less than 5% in two other areas], negative DRE, bone scan and Endorectal MRI. Completed 39 Proton radiation treatments 2/22/07-4/18/07.
First PSA test to be taken 7/07.

Post Edited (pcdave) : 6/17/2007 6:16:57 AM (GMT-6)

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