Another Old Codger just learning of t... - Advanced Prostate...

Advanced Prostate Cancer

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Another Old Codger just learning of this site

6timeAuthor
6timeAuthor

I'm new to the site (as of today, 8/1218) and was referred by a friend. In reviewing several posts, the thing that strikes me is that most of those reporting various levels of prostate cancer also had bone scans, recommended by their urologist. Last year, I had a biopsy and the result was one small sample had a low percentage of cancer and a Gleason score of 3+4. My PSA was 3.00. Monitoring the situation every 90 days, the urologist suggested we do another biopsy after 3/4 of a year instead of after a year. PSA remained about the same, maybe even dropped a bit, but this time, TWO biopsy samples had cancer cells, and each are now was a 4+3, suggesting the cancer was spreading. Because I'm in my early 80s, I was told "nobody is going to cut on you," but instead, I will begin radiation therapy as soon as Aug 22. NO ONE has even suggested a bone scan. Two questions: (1) has anyone had experience with radiation (up to 45 days) and if so, were there any side effects? (2) How important is getting a bone scan at this point?

13 Replies
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Bone scans only for men who are high risk. You are intermediate risk. You should talk to radiation oncologist who specializes in SBRT it’s done in only five treatments.

And fewer sessions would mean fewer side effects. None of the radiation side effects are particularly disabling, but if you can minimize them, all the better. I’ve had 37 sessions of adjuvant radiation after surgery failed and collectively 20 sessions of palliative radiation over three courses. For me the worst of the side effects were fatigue and colon irritation (during the first course). There are ways to deal with the side effects. Best to you.

Yost, or others please correct my thinking if I'm wrong. You say fewer sessions would mean fewer side effects. My husband had 10 spot radiations for a vertebrae at a low dose. I assumed doing low dose spread over 10 might reduce side effects.

I see where some docs would use 5 at a higher dose. I have a friend whose doc used 1 dose and that really hurt him.

I am so clueless about radiation.

Also, the color irritation you experienced. How long did that last? I do know everyone can react differently. I don't even know the questions to ask. Any ideas.

My colon irritation resolved within a few weeks after radiation finished, but then about two years later, I had some bleeding. That also resolved without major intervention.

I suppose fewer sessions at higher doses can still produce significant side effects. I think my most recent radiation to my rib cage affected my stomach. Overall, though, I suppose I've been fortunate that my radiation side effects have been minimal and manageable.

As usual, Mr. Tall Allen is spot on.

I would say that you need an MRI scan of your prostate before you let them poke or cut your tissue again.

If you read around here, there are different types of MRI scan equipment (a lot of people keep out of date equipment in service for cost containment purposes). Those other posts might inform the type of scan you select.

I had a negative MRI before my biopsy, which showed a 9/10 Gleason score involvement. Wouldn't trust an MRI as a diagnostic tool at all.

WayneSC
WayneSC in reply to Flydoggy

My urologist whose wife is a radiologist, does not use imaging tests for diagnostic purposes. Somewhat surprising.

cesanon
cesanon in reply to Flydoggy

The most current MRI equipment and technique is supposed to be at least as good as the biopsies.

That isn't hard to do as the biopsies to my recollection have a 20 to 40 percent sampling error.

It is probably a no brainer to supplement any biopsy with a current state of the art MRI.

They can each see things the other may miss.

Actually with current technology it seem that the proper order should be:

PSA test

MRI test

Biopsy

You could also just monitor it and get an MRI as mostly it is a slow grow. For me it would be a hard call. I also know of a man in his eighties that had a RP and he is fine. He was in good shape.

I finished 45 treatments about 3 weeks ago and my side effects were using the bathroom, 1 & 2 all day and night and because of using at night, I was very tired because its hard for me to fall b ac k to sleep. I still have the same sided effects but there starting to fall off.

Ray

to: Author1 Author2 Author3 Author4 Author5 Author6

If your medical coverage covers the bone scan... then get one. Early 80's (you can tell us the exact number, we won't tell)...avoid the 45 days of Frying and listen to the almighty guru TallunderscoreAllen's advice (above, he knows his stuff).

Good Luck and Good Health.

j-o-h-n Monday 08/13/2018 2:47 PM EDT

According to a 2008 video by Dr. Gerald Chodak ( youtube.com/watch?v=QSF1vmD... ) for men who have not been treated before, a bone scan is only useful for men with PSA > 20. For patients with PSA below 20 the bone scan will find cancer in 0.3% of men who get the test. But 13% of such men will get a positive result due to some other condition, for example an old injury.

So the bone scan may provide false information while offering no benefit.

Alan

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