good evening all! I am at the Mayo Clinic Rochester, mn. I have had a week of tests, scans and other stuff. My pet scan showed lung involement. Had 4-5 polyps removed - benign! But todays pleuroscopy showed cancer in and on lungs as well as on my diaphragm. Stage four. I learn hopefully this Friday course of treatment. I had my prostatectomy Oct 2016 and a Gleason 10 age 65. Am on casodex daily and lupron injections every three months. My question relates to anyone with lung mets? And treatment? I have been told radiation is probably out due to broad area of involvement. Thanking you all in advanced! Fight on guys!
David
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bjorner3
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I had a 3 cm spot on my lung when I was dxed in 2006, It was later determined to be an unrelated benign event ofter furthur scans and xrays determined it remained the same when my other mets shrank with therapy, may have beeen a fold or an earlier scar. I think it is important to see if it shrinks with your current therapy I do not know of any specific treatments though if it is from your Prostate Cancer , it should shrink when your systemic therapy is working.
Thanks Dan Unfortunately scans from a year ago show lung mets (pre radical daVinci prostate removal and pelvic dissection Oct 2016) and three drs missed it. The mets are clearly visable from a year ago. (I have been on lupron for ten months and in third month of casodex. ) As you might think much bigger now. The year old scans were taken purposely to look for any mets (MRI and CT scan) but missed big time (not by Mayo!). At Mayo their tumor Board - docs of many disciplines are figuring my treatment path but they express udder amazement the mets were missed. I am malignant.
I have PC which spread to lungs, liver, and bones. I am on ADT plus Chemo( Docetaxel + Carboplatin). The Chemo has controlled my mets from growing during the last nine months.
I am dealing with lung mets and a new growing mass/node in my mediastinum (between the lungs). I have been on Lupron and Casodex for over 8 years with good results until now. I also have extensive pleural mets. All this with a Gleason 6 pathology 20 years ago.
I will be starting enzalutamide (Xtandi) next month. PSA is just now approaching 2.0.
My summary:
Bob Lederer: Diagnosed November 1996, age 56, bPSA 11.6, Gleason 6(3+3), T2a, Gland size 75gm, EBRT 2500Rads, Lupron x1, 98 I-125 seeds implanted in Seattle (Seattle Prostate Institute) by John Sylvester in April 98. Partin table prediction: 55% chance outside capsule.
Impotence after 2 years but responded well to Viagra. PSAs fell and had expected bump at 18 mos. All below 0.1 until 7 years out. June 2008, (11 years out) rising in a linear progression but accelerated doubling time from 12 months to 7 months. Currently 2.91.
August 1, 2008-Focal Cryoablation at the University of Colorado Urologic Cancer Center. Preop PSA was 4.2. Prostate size 18 gms on color Doppler.
PSAs rose post op so Bone Scan and CT ordered. Scan neg but CT showed Left Lower Lobe lesion in lung. CT/PET scan showed activity in lungs and thyroid. Hemithyroidectomy March 2009, benign tumor. April 15 scheduled lung biopsy. Found extensive small mets on pleura of left lung. Biopsy revealed PCA in mets with cells appearing very similar to original cellular description from 12 years earlier. PSA was 11.8 at time of biopsy.
ADT begun with Lupron on April 26. 2009.
Early 2014 PSA’s 0.3 until August=0.35. Sept0.45
Repeat PET scan, April 2014. No activity noted
Follow up Bone density in April, 2011 also normal
T =10. Baseline bone density normal and Vit D normal.
Current therapy is Lupron every 4 mos. Zometa every 6 months (IV infusion)
Hot flashes present but tolerable till 2014. Added Estradiol patch 0.225 mg weekly, to control hot flashes. (Avoid sleep disturbance)
PSA rises were very slow but linear. Max 1.64 in August 2016. Casodex added with drop in PSA for 5 months but nadir was 0.82. Now rising linearly again.
PET scan 8-11-17 showed new activity in posterior mediastinum with a 3.5cm mass.
Thanks Bob. I haven't been in this game long but sure as hell am now on the team no one wants to be on. Will list details now.
July 2016 difficulty voiding bladder led to referral to urologist. PSA 16.
Urologist did biopsy Gleason 10.
Urologist waited for a month of healing from biopsy then ordered MRI and CT scan to rule out mets.
Had radical prostatectomy with pelvic lymph node dissection ( clear nodes) stage T3b so seminal vescicles removed. October 2016.
Dec 2016 PSA was 5.69 so put on casodex for five weeks. (50mg daily) That brought PSA down to 3.9.
January 2017 first lupron injection. Get one every three months.
April 2017, PSA at 0.44 and lupron injection.
July 2017, PSA at 0.99 put back on casodex and still getting lupron injections.
During this time frame April to now developed a cough that wouldn't improve. Mentioned it to urologist in July. Nothing done or investigated.
Went to Urgent care doc got put on augmentin for cough. No change. Referred to pulmonologist. Ended up going to Mayo in Rochester Mn on my own referral. Diagnosis: stage four cancer in lungs and on diaphragm. Should find out type cancer today at appointment.
Kicker is at least three docs including local radiologist missed cancer in lungs which was evident on MRI and CT scan done pre-RP. Mayo was shocked it was missed it was that evident.
So that is where I sit today. Hope to know more today. Suspect they will want me back next week.
Thanks Bob! I appreciate hearing from you. I especially like the number of years you have been ivolved with PCa and are still here!!!
David
I was diagnosed with lung mets 2+ years ago. My oncologist put me on Zytiga, since then they have been stable (although PSA continues to rise).
This may be apples to oranges but here it is anyway:
K E Y T R U D A.
Just to let you know that I've commented here before about my Keytruda treatments I receive one every 3 weeks (had one last Tuesday 09/26, my 7th one) for my lung melanoma. So far it shrunk my tumor by 3/4 of the size. My lung melanoma is NOT related to my PCa.
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Update on my daddy- 8 years stage four 
Advice: Mutliple Ribs, Pelvic and Lungs mets
Father diagnosed stage 4 June 2019, mets to pelvic bone, liver and lungs
Advanced Stage 4 Prostate Cancer with Mets
Stage four very aggressive prostate cancer 
