Always learning

[docbulldog]

I had surgery on 06-06-2006 with path reports showing positive after surgery.  PSA moved upwards so I went through radiation treatments in early 2008 for 12 weeks, but found PSA started rising again, we waited and watched until it jumped from 9.3 to 14 in June 2014,  I then started injections of Leupron  every 3 months and Xgeva every month for 1 1/2 yrs, I now have both injections every 3 months. My PSA has remained between .45 and 1.1 for the past 1 3/4 yrs.  A bone scan reveled 2 spots on bone prior to the start of injections. I have asked about having another bone scan to check on bone metastasizing but was told as long as PSA remains < 1 it would not be needed.  Does that sound correct or should we be looking for growth in the tumors?

[pjoshea13]

If PCa cells are producing PSA, the PSA doubling time is indicative of tumor growth rate.  Thus, your cancer appears to be stable, & a bone scan would simply verify that.

Regarding tests, in general - before I ask for a test, I always think about how I'll use the result.  If the result isn't going to potentially cause a change in therapy, what is its purpose?

-Patrick  

[docbulldog in reply to pjoshea13]

I was wondering if the two spots that were detected on the scan two years ago were causing some of the back pain I am experiencing off and on. I guess it would also give me a little peace of mind. Thanks for your response.

[boc13]

My husband has a very similar history. In 2007 after surgery and lupron before radiation, his psa was pretty steady at .01 for about 3 years. It went to .02 in 2010. Slowly rose over the next year or two. When he was at 1.15 or so I felt that he wasn't doing as well as he had been. In 2012 and again in 2o13 I asked his dr to do a bone scan. He told me his psa didn't justify. In early 2014 I asked him again his psa was still under 2, and again he said it would not be in his bone because psa was still under 2. I told him I was seeing a change and I was concerned it was in bone. He told me know way at 1.4 and sometimes psa would drop and then go back up. Late 2014 he passed out. This prompted er to do a scan of upper body and a bone lesion was found. They radiated that lesion. His psa is still, or at least as of Jan under 2. They now do scans every 6 months, sodium fluoride, pet:MRI and have not started any meds yet. They do psa every 3 months as well. Go with your instinct and if you feel bone scan will help in some way, insist. Psa doesn't always tell you what's happening.  Btw his psa at 49 was 70. We would have thought it would be a good indicator gage after surgery and radiation But wasn't. Follow your gut and the best for you. 

[docbulldog in reply to boc13]

Thank you for the reply to my situation.

[JoelT]

I am wondering why you were started on Xgeva while you are still hormone sensitive?  Usual practice is to delay Xgeva and the similar drugs until you become castrate resistant since these drugs when used for long periods significantly increase the risk for very serious fractures, especially of the femur.

Joel

[docbulldog in reply to JoelT]

Good question...I was receiving Xgeva injections every month for 15 straight months, then my new oncologist changed my prescription to every 3 months to go along with the Leupron infusions. After having my PSA jump so rapidly, I was ready for their care and direction.

[Aussiedad]

Do ask for a Gallium 68a PSMA PET scan which is the latest and detects very small size cancer activity. This scan is far more effective than MRI scans and is the leading edge scan ... The half life of the radioactive agent is only 68 minutes which is very short and produces minimal damage ... The forerunner scan was Choline based and only lasted 6 months use withe the rate that the technology is developing.

Had diagnosis of Prostate cancer in 2004 with Gleason of 3+ 4 which led to radical prostatectomy on Zoladex for 12 months followed by radiation of the bed of the prostate and then on Leuprin (Leupron) intermittent 3 monthly injections - to try to avoid resistance to the Leuprin. Very strong side effects like extreme fatigue, aches and pains, some memory effects etc., etc., but it has kept the PSA down so it's better than the alternative!

Cheers, Aussiedad

[docbulldog in reply to Aussiedad]

I appreciate the response to my situation, I will talk to my oncologist during my June visit.