If yr PSA reading is Undetected?but bone scan shows slight dark shadow on lower vertebrae?

High folks,quick up date?I recently finished my Radiothereapy about two months ago?saw my Onc and complaint about back pain as I was painting my house?so she sent me for bone scan and but my recent blood test after my Radiothereapy showed Undected which was good news I guess?but bone scan showed up slight dark shadow on lower vertebrae?can some one on this forum shed some light on this matter pls?if PSA showing undetected level he comes I have this dark shadow on my Lower Spine area? Due to have a MRI scan on the 2 August?any more experienced folks on this forum?can shed some light I be very grateful 👍

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  • Hi Nuray,

    Same thing happened to me with my bone scan which identified suspicious metastatic tracer uptakes in my bilateral shoulders and the sternum. A subsequent MRI to evaluate these findings, interpreted them as trauma/bone degeneration and not PCa bone mets. My PSA has remained at 0.008ng/ml for more than 2 years. I cannot exactly understand on what basis, two of them interpret their findings differently. But I think MRI is considered as more accurate. Measuring of the serum level of Alkaline Phosphatase is also a relevant test to establish the facts. As for me I am happy if some test confirm that I have no bone mets but to be frank God only knows!

    Sisira

  • Yes sisira,it's just a worry when you here PSA undetected and shadow appearing its constant worry

  • I have 2 anecdotal examples of bone scans:

    1) My wife had a plasmacytoma treated (radiation) in 2015. In 2016, her oncologist said she had several more. He initiated aggressive therapy (Velcade) & arranged for her to have stem cell replacement. The people at Wake Forest thought she was crazy. "You have another solitary plasmacytoma." Don't even think about stem cell replacement. 2.5% of patients die during the procedure.

    It all depends on how you interpret the scan. She now has a more conventional oncologist who actually shares test results, including scans.

    2) I had metastatic PCa at L5 & found a radio-oncologist who would would treat it. Afterwards, I asked about the other areas mentioned in the bone scan report. Ribs & collar bone. He was emphatic: "Those are not prostate cancer!"

    The person who reads the scan is obliged to report all anomalies, often with weasel words such as "consistent with" PCa. When I saw the scan, the L5 stood out as being pure white (osteoblastic), while the other areas did not. In my wife's case, her solitary plamacytoma stood out as being black (osteolytic), while other areas did not.

    -Patrick

  • I once viewed a video produced by Dr. Gerald Chodak, a urologist in Chicago. He said that studies show that 13% of patients will have a positive bone scan even if there is no cancer. With an undetectable PSA, your chance of metastatic cancer is way below 13%, so I think the odds are very high that the shadow on your bone scan is not cancer. The odds are high that the same shadow would have appeared before you ever developed cancer. It's most probably due to something else, probably something that's been there for years and possibly even since birth.

    You wrote: "... my recent blood test after my Radiothereapy showed Undected which was good news I guess"

    There's no guessing about it. It's good news. My recommendation would be to continue to monitor your PSA, to work on your back problem (maybe with physical therapy), and to enjoy life.

    Best of luck.

    Alan

  • Thank you Alan,hope it's not cancer and arthritis or some thing in that nature?what worries me is my cancer breached the prostate gland Alan?had nine months undetected PSA?then the next three quarter blood test showed 0.4 0.8 then 0.13 and that's when started Lupron hormone injections and had 36 days of Radiothereapy to the prostate bed 66grey most recently?

  • I agree with all, degenerative bone disease, from older injuries can show and sometimes they may call them suspicious. When I was first diagnosed I had what they thought was a 3cm tumor on y Lung, which in later years , through no change in scan and was determined to be a beniign unrelated event, big scare before that though.

    Dan

  • It sure is dan mate?its a constant worry Cancer 👍

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