Disappearing bright spot...

[Don1157]

Have you had this experience? Spot on rib glowed during bone scan after no treatment for 6 years, PSA was on the move up to 8 from .02 nadir...started Lupron again for 1 year...going intermittent, the PSA up after Lupron, went to Decatur, Illinois (good people there) for PET scan, but the rib did not glow in C-11 PET scan. Speculation about broken rib healed incorrectly, or is it dormant? C-11 scan showed nothing in the rib, no Lymph nodes glowed, but there were two bright spots in the prostate. So now, maybe it never left the prostate?!?! Still in limbo, right now no biopsy planned for the rib, and treat the prostate again, with brachytherapy this time. Had radiation at first, 2009 PSA 42 at age 52, 60 next week. What a roller coaster, and the ride will go on!

[AlanMeyer]

I haven't had the experience, but I do know that bone scans will frequently reveal abnormalities that are not due to cancer. Dr. Gerald Chodak has a video about bone scans in which he says 13% of patients undergoing a bone scan will see something that is not cancer - perhaps an old bone fracture or a congenital problem. I'm no expert but I think I'd trust the C-11 PET scan more than the bone scan.

This is excellent news for you because there is at least a possibility that retreatment of the prostate will resolve the problem for you.

Best of luck with it.

Alan

[Don1157 in reply to AlanMeyer]

Thanks Alan, I've been in a couple of accidents and I had open heart surgery, a year after Lupron, by the way, and they do fillet a guy. The difficult thing is that it has been hurting recently, the rib anyway. I have muscle spasms in that shoulder as well. I am going to visit with a radiation oncologist again and may send the pictures for a second opinion. In some ways, this is a good thing, as it may mean that the PC never left the prostate, but not holding my breath on that one. So much want to avoid Lupron again. Thanks again for the feedback.

[AlanMeyer in reply to Don1157]

Don,

I think the C-11 scan is more specific and more sensitive for prostate cancer than the regular old bone scan - which shows all kinds of abnormalities in the bone - not just cancer. So I'd trust it more than the bone scan.

As I understand it, with a PSA of 8 after recurrence, the odds are high that you are metastatic and new radiation won't help you. But I have heard of cases of localized recurrence and it's possible the new radiation will stop it. I read of one case of a man with a PSA of 20 whose cancer was successfully treated with salvage radiation. Unfortunately, single cases like that are poor prognosticators of anything. It's always possible that errors caused some aspect of the story to have been reported incorrectly.

In any case, if you do have to return to Lupron, please try to think positively about it. I remember when I was on it, every time I got a hot flush I would think "Good! The drug is working to kill my cancer!"

Dealing with ADT is a challenge but it's one that, if we can't completely resolve it, we can at least make a lot of progress on it. Here's a link to a posting I made a while ago along with replies from others that include other resources:

healthunlocked.com/advanced...

Best of luck.

Alan

[ctarleton]

Good luck with the brachytherapy, Don1157.

Here's hoping that you get a good result for everything showing on the scans this time.

Your past familiarity with Lupron might serve you well if they should suggest getting some temporary Lupron in addition to your brachytherapy. You've already "been there, done that".

Keep us posted. Enjoy this Holiday Season.

Charles

P.S. I've seen small things come and go on NM Bone Scans. One scan was shortly after a fall that had "jammed" an elbow. The bones were not apparently broken on X-ray imaging, but the bone scan did "light-up" a bit where the ends of those bones were probably still doing microscopic level remodeling to completely heal themselves.

[Don1157]

Appreciate the perspective Alan! I remain concern about the effects on my heart. Yes, Charles, have been there, temporary may be ok.