We've all had the same kinds of imaging, some of us countless times. But, when it comes to met progression, what would you consider the proper test to have?
My mets were found using a Flouride Pet Scan, and now my MedOnc wants MRI's and a Cat Scan to check my met progression. I'm a bit leery of this approach. This is the same guy who derided genetic testing. I have an appointment later this month to have it done, I'm not sure what gizmo they'll use.
Joe
I had genetic testing done when my cancer spread to my liver. The only positive thing the results showed was that my cancer is not genetically transmittable so I told my relatives but it has not helped me. May be worthwhile if more people had it but not right now.
My mets first showed up on a good old X-Ray as an abnormality on the lungs. A CT-Scan showed where the mets were. Strange I had an MRI a couple of months earlier and no mets were seen. For me the CT-Scan seems to work well along with a bone scan.
My doctor is recommending CT and T99 bone scan following completion of 6 rounds of Taxotere chemo to get a baseline for future comparison. In general, I agree with this approach. Compared to CT, MRI is better with soft tissues and bone marrow and has better sensitivity and specificity. But CT is better in areas like the ribs where there is less bone marrow. So both have advantages. And of course there is PET scan which is excellent, but I think in most cases that is not done because of the high cost.
Elgie gets the f-18 pet scan but Dr. Myers is the only doc who we have had who will prescribe it. His local oncologist will not prescribe it. They say it's too sensitive and picks up too much......
Hi Jackie. Now that Snuffy retired, I hope you've been able to find a replacement for Elgie among the med onc's Snuffy recommended, or that you soon will. Good luck!
Neal
Hi Neal!
We are not able to go tomorrow. Elgie hurt his already bad back and can not ride that far. Thank you so much for your kind words though and we will probably be seeking out the University of Penn. For now he is going to continue his Trelstar injections locally. After he gets his F18 PET scan and his CT scan and is bone scan we will know a little bit more of what he is going to do and who he will seek out. How are ya doin? Happy day to you and the rest of our extended family here 
I hope everyone have a fabulous day and that your Furry Friends weren't as crazy as mine from all of the fireworks 
Most sincere
Jackie
May the Fourth be with you, & all of us. Sorry about Elgie's back. Good luck on the scans, & with Penn. I'm 2/3 of the way through Provenge every other week. I've had 2 white blood cell extractions on Mondays & 2 infusions on Thursdays. The extractions are tiring, & their chair/bed is bad for your back (I'm gonna bring pillows to the last 1. I've had Yvonne drive because I'd heard how weak you feel afterward. The first infusion was easy, although I had to drive a ways. My sore ankle was bad enough for the 2nd that I had Yvonne drive, & drop me off right outside the building before parking in the lot. I had a big infusion reaction, sleeping most of the time from Thursday night to Saturday afternoon. I had no appetite, which NEVER happens. When I started to heat food, I got nauseous. This is my week off, & next week is the final part.
Sincerely,
Neal
Oh yeah, pets. After my beloved black cat of 13 years, Trane (John Coltrane), died a couple of years ago, I agreed not to get another. Yvonne had developed an allergy, & it's easier at this point in our lives, when we're retired & doing some traveling, not to need to worry about having someone stay here who will care for a pet. I must say Trane didn't seem that concerned about fireworks, especially if I was petting him. That said, on Monday there was a 2-block long force of deputy sheriffs, police & firefighters on the cross street a few houses down. We heard they were taking out a fireworks lab in the neighborhood. Since then, our neighborhood has been quiet, although we can hear constant explosive & percussive sounds in surrounding areas. And Monday night there was a fireworks show a few miles away at the Coliseum, after the Oakland A's played. I'll see how Rosie, the cat next door, & the dogs on the other side did. How was it for your pets, Jackie, & how bad is it where you live?
Oh Neal....that's alot of treatments. I hope and pray they are working. Yes, take pillows! It's great that you have Yvonne to drive you. Elgie uses ginger candies suggested by Charles Eric Winter but I'm not sure they would help your kind of nausea. Hoping, wishing and praying that all goes well with your final treatments Neal.
Your kitty cat sounds awesome to not really care about the fireworks. None of our kitty cats care about the fireworks but my Ella.. my dog is a spaz. She already has anxiety severe and fireworks don't help any. The furry friends are the thing holding us back from traveling ourselves. We weren't together when I acquired all of my fur children. Now.....well.... now it is what it is. Thank goodness we did some traveling when we were able to. We live in a very nice neighborhood and there is not too many fireworks. We live in Amish Country. My Ella does not forget even when they stop though.
Baby that ankle and be good to you. Rest until you're well
Most sincere,
Jackie
I had a cat named Ella (Ella Fitzgerald).
So much for the neighborhood story we heard. I just read what really happened Monday afternoon in our daily paper. 4 juveniles stole a cell phone in a Starbucks, in another city. They took off in an Infiniti. Police chased, aided by the victim's wife's Find My Phone app. Police found them on the freeway near us, & the Infiniti took off on city streets. It crashed into an unoccupied car a block away from us. Firefighters used heavy equipment to extract 2 from the wreckage. One was in bad shape but will survive. The other 2 ran away. One was caught quickly. The other was caught by using police dogs. All were in custody within 53 minutes of the robbery.
I hope you find a pet-loving house sitter so you can travel. We've used friends, family, & friends of friends & family. Everyone wanted a place to stay, & no $ was exchanged.
I spoke too soon about the local silence. A few seconds ago, there was a series of booms about a block away.
I've had some time today because we had our party a day early, so people didn't need to drive when the drunk drivers were having their big day.
Wow! Lots of commotion in your area Neal! A cat named EllA I like that. We stayed home and had leftovers on the 4th. My neuropathy has been acting up so we relaxed. Hope you're doing well today. It is so hard to believe how difficult it is nowadays to find the right person to sit for your furry children. I used to do that for anyone I knew sit at their house for free and just enjoy another home. I have tried several and been quite disappointed. Nephews nieces friends. My son was the best one when he lived with us but now he has his own unhealthy life and he is not able to. Most of my furry friends are special needs friends. Thankfully we are thoroughly enjoying the wildlife around our home. That is a major highlight for us
Ba Ha ha May the 4th be with you!
>We live in Amish Country... >local crimes...
Reminded me of the old joke. What goes, "Clip Clop. Clip Clop. Clip Clop. Bang! Bang! Clip Clop. Clip Clop. Clip Clop."?
Answer: Amish Drive By.
Seriously, though, the Amish have some very interesting cooperative practices when it comes to medical expenses and medical insurance.
Charles
Too cute Charles about the amish drive by. Interesting Medical and insurance practices.........curious. what part of amish country are you in Charles?
Actually, I've lived in Northern California most of my adult life. I've just seen documentaries and read things about the Amish and lots of other things over the decades. My Sweetie grew up in Coopersburg, PA. Her son used to go back to visit summers with grandparents when he was a kid. I visited there a few times, myself, as all of us got considerably older.
The oncologists in London seem to have decided that MRI is the gold standard. I had a whole body scan. This showed a single metastasis on T10 vertebra and nothing else. This was great news as they were able to use Cyberknife to zap it - permanently I hope.
Bob
It seems docs always deny whats not available to them. They are harassed by health providers.
Good old fashioned CT and Bone scans are what I get on a regular basis because I am on a Clinical Trial. They seem to be able to tell a lot by those two. CT is for organs and Bone Scan is ....well for bone mets! Those two gave a clear picture of my PC at initial diognosis and continues to provide me with same. Lymph node tumours have shrunk and Bone mets show healing. If these reverse will be when I go off the Clinical Trial and back into "regular Chemo/radiation treatment ".
I get CT scan & Bone scans, also shows my liver & lymph mets. PET is available, but not encouraged and considerably more expensive.
I asked my dr. early on about whether or not there were any MRI's in my future because I have claustrophobia. Thankfully he said that Bone scans and CT were just as effective. So glad because even the 1st bone scan had me in a panic.😬
I agree with the other respondents. I have had PET and MRI but my medonc seems to prefer CT Scan and Bone scans for base lines and comparisons. I do have to say though, about two years ago they couldn't find any met but my PSA was still high and I had a PET done that discovered my lymph nodes around the bladder had several growths. Since then they do CT Scan in the pelvic area and nuclear bone scan (not that often) to see if anything has spread to the bones.
Lou
So far, the concensus is CAT Scan and Bone Scan. I don't think my Onc is up to snuff with PCa. At this point in time, I think an MRI would be useless.
Joe
Well each of these tools, have different capabilities and costs. a 3T+ MRI with endorectal coil, is only used during initial evaluation to allow close detailed examination of the prostate, bladder, and rectum, to see the extent of tumor growth and invasion of surrounding tissues. Also used to guide surgical therapy. CT can only see tumors of about 1 cm in size. Bone scan uses radiation dye to see which bone areas are soaking up the dye to identify actively growing tumors. PET scans are more expensive and routinely provide too much unnecessary detail, at greatly increased cost.
Well put.
What I get routinely at Kaiser Oakland (CA) is bone & CT scans with the equipment they have onsite. Once I had an MRI, which seemed to allow more precise info. I've been jealous, reading & hearing about all the fabulous scans guys are getting.
But when I consulted with the famous med onc Mark Scholz in LA, to my surprise he thought the scans I'm getting are fine for my present purposes. I'm beginning to develop more trust in the care I'm getting, now since the med oncs began specializing a couple of years ago, & they have a UCSF-trained urologic oncologist I like as the head of the genitourinary team.
I guess we all need to inquire periodically, & to have this discussion again here periodically.
Neal
P.S. Last year, Chuck Maack recommended the annual conference for PCa patients & caregivers given in September by the Prostate Cancer Research Institute, headed by Mark Scholz. I attended. It's very worthwhile, & quite inexpensive. It's probably time to look into it if you'd like to get the early enrollment price. I'm going to check right now.
You may be able to easily participate in a clinical study for the new PSMA scan. Where are you located?
Who, me? I'm in South Jersey, not to be confused with North Jersey, which should be a part of NYC. Really! We're that different here. They have Taylor Ham, we have Pork Roll. Whatever.
I have access to high end care, but what constitutes high end? Because Philly is right there? No. I do have an appointment coming up for genetic testing, something my Onc isn't in support of. I can't understand him. Anywho, I'm waiting eagerly to meet with this new group, and they may do a PSMA. Here's to hoping.
Joe
FYI: New data on progression of visceral mets without PSA progression (discordance) and ARAT/docetaxel therapy
Advice for stopping/slowing PCa progression. 
Having SABR radiotherapy to 61mm met on my hip
SABR to oligometastases slows progression via immune response
Imaging for metastatic PCa
