Advanced Prostate Cancer
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What is meant when told that a met has been "resolved" after a mid-chemo CT scan?

I have had a prostatectomy in March 2014 and the tumor was given a Gleason score of 4+3. When my PSA rose to 0.91, I received radiation treatments in June 2015, causing my PSA to decrease to 0.63. Last fall, however, my PSA had risen to 16.8, and I commenced combined hormone therapy (Lupron) and chemotherapy (docetaxel) in late December 2017. Before starting this treatment, a CT scan was conducted in late November 2017, which identified four nodules determined to be "concerning for metastases" on my right lung: a 9x8x8 mm nodule and a 9x8x7 mm nodule, both in the right upper lobe; a 5x4 mm nodule in the right middle lobe; and a 6x3 mm nodule on the right major fissure. I now have completed three of six docetaxel infusions, and another CT scan was just completed that found: one of the nodules in the right upper lobe "has resolved;" the other nodule in the right upper lobe now measures 3x1 mm; the nodule in the right middle lobe now measures 3x2; and the nodule in the right major fissure "nearly entirely resolved". My PSA now is <0.1. I find this very encouraging, but it is my understanding that PC metastases are not eliminated by either hormone or chemo therapy. Does the use of the term "resolved" merely mean that the tumor is no longer detectible by a CT scan or does it mean something more?

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I think it means that there was an interval change when comparing the images and the nodule is not longer seen. An encouraging result.

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Be encouraged---your PSA of less than 0.1 may last you a long long time. I just Prayed it will.

Nalakrats

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I take it to mean that it can no longer be seen by the resolution of the CT scan. That, and a PSA <0.1 are really about as good of news as you can have. You are right that hormonal therapy does not kill but starves cancer. Radiation and chemo, however, can kill it. But either starving or dead, the cancer is in retreat. Again your news is about as good as you can get! I hope you celebrate this wonderful result! I, for one, am ecstatic for you!

Walt (a retired chemist not a medical doctor)

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I am learning something new everyday from you guys! This is awesome! So is there a maximum amount of times you can do the Hormonal therapy?

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I don't think there is a maximum time for hormone therapy. I have heard of a man who has been on Lupron for 30 years and several men who have been on it for more than 20 years. Chemotherapy is tougher because it has more side effects than HT, but if you have a good response to it might work again in the future if it's needed.

Among all the unlucky guys who get prostate cancer, there are some who have at least some good luck in having good and long lasting responses to treatment. And as the treatments get better, as they have been doing in the last few years, the number of lucky guys is increasing.

Alan

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I have an advanced case of a very rare cancer (Ductal). The plan is for me to be on Zytiga (with prednisone) for two years and Lupron for the rest of my life.

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Dr who what exactly did your pathology report say...mine said andercarcecenoma with ductal hystology...perineal invasion...gleason 5+4....after scan bone met to pelvis rambus........my thing is no docs have said word about " the ductal" except its more aggresive....and rare...what did you hear...thanks in advance kevin

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You are right that it means it's no longer detectable. I'm glad the chemo worked so well for you. It doesn't mean anything more than that - once you are metastatic, you are always metastatic, even if you can't see them. To reach a distant place like the lungs, the cancer cells had to travel in your blood or lymph before a few of the thousands of cells took root there. I think of it like fungus under an oak tree - the soil is saturated with the fungal mycelium, and occasionally mushrooms will sprout. Picking the mushrooms doesn't destroy the fungus.

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Just good news.. must be a relief after all that you’ve been thru. Congrats and good luck with continued Improvement. It’s going well .. Ride the wave..

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Same here. At diagnosis in 2015 I was Stage 4 with one bony mets on the inferior pubic Ramos, confirmed by (a painful) bone biopsy of the spot. On my next follow-up PET scan, the bony mets failed to “light up” and the narrative report showed interval resolution. I’ve never had any bone pain, and my PSA has been undetectable ever since I started on Lupron/Eligard and bicalutamide 3 years ago. I’m head up to the Mayo in Jax for my 6th and final dose of docetaxel. Life is good. Golfing today. I pray daily for all my brothers in this forum. May you all be blessed with a long, healthy life. Your posts have been very uplifting and informative. Have a great day everyone. 🏌️⛳️😎. Mark

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Sorry for the grammar. I need to check these things better before I hit “reply.” 🤪

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Now all you need is a hole in one....

(Fore)

Good Luck and Good Health.

j-o-h-n Friday 03/09/2018 7:13 PM EST

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Way to go....

Good Luck and Good Health.

j-o-h-n Friday 03/09/2018 7:14 PM EST

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