Lytic bone metastases?: Just had a CT... - Advanced Prostate...

Advanced Prostate Cancer
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Lytic bone metastases?

Bill48162
Bill48162
18 Replies

Just had a CT scan done and my MO spoke with me regarding the tumor on my L5 vertebrate. It's been there since I was diagnosed 3.5 years ago. My MO is concerned that the L5 tumor has/is becoming Lytic in nature.

Has anyone ever experienced this situation? Does anyone currently have a Lytic lesion? If so, how was/is it being treated? I have an upcoming appointment (two weeks) with a radiology oncologist to discuss the situation.

I'm experiencing no pain in my L5 area.

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Tall_Allen

Was a biopsy done? What about blood work - chromogranin A, synaptophysin, etc?Recent analysis shows that mixed-type neuroendocrine PC is more common than was supposed.

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Bill48162

No biospy yet. My calcium, alkaline phosphatase, and uric acid numbers are all within range. Would vertebroplasty, etc be an option? Thank you, I was hoping you would respond.

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Tall_Allen

They have to dig deeper to detect neuroendocrine. I don't know anything about vertebroplasty. I remember one patient told me his had been carefully dug out and his vertebrae fused. They biopsied what they dug out.

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Dan59

Bill, has this l5 spot remained the same while all the rest of your cancer has greatly reduce on scans? Other than to say a tumor that has not changed in 3.5 years while others have reduced is suspicious for not being related to prostate cancer ,and may even be benign (non cancerous)IMO. Why does the MO think it is turning lytic? I am sure Tall Allen has better advice, I am thankful he is here for us. just my thoughts. A bone biopsy could settle your mind on this issue.

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Bill48162
Bill48162
in reply to Dan59

Dan, yes the L5 has pretty much stayed the same from the start. the 4 other mets are no longer visible. No soft tissue involvement. All nodes back to normal size. MO thinks it could have become lytic due to L5 "change" on my ct done Tuesday. I'm guessing a radiologist At U of Michigan cancer center will confer will the radiology oncologist I'm scheduled to see in a couple of weeks. My only concern is a vertebrate fracture or possible spinal compression. Funny thing is, I don't feel a thing.

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Dan59
Dan59
in reply to Bill48162

I suspect it may be a shadow they are seeing or something else, I seriously doubt with your results and weight training you are anywhere near Spinal Chord compression, but I know those are the things we worry about it when we read a lot, I certainly wish I had worried less in my first decade. Are you on xgeva or zometa? Have a good day tomorrow Bill, I will be thinking of you.

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Dan59
Dan59
in reply to Bill48162

When I was dxed, they saw a 4cm lung tumor, and that really looked bad for my survival. After a while on adt my other tumors all shrunk and the lung tumor remained the same, after a lot of radiography it was determined to be an unrelated benign event, and still shows the same as it did 12 years ago on my current scans.

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tango65

Since the great majority of the bone lesions in prostate cancer are osteoblastic , you should discuss with your MO the possibility of doing a PET/CT study or a biopsy to determine if it is PC. If it is possible to do a biopsy you could get a somatic genetic study.

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henukit

My two (and the only) detected bone mets are lytic. Biopsy was done on a smaller one from L3 and I didn't get much information from pathology report other than they found traces of cells reminiscent to PCa. I'm surprised with the scarcity of data coming out of biopsy. As for chromogranin A, synaptophysin? First time I hear about those, I guess need to dig deeper and ask some questions to my MO. Thanks Allen.

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Bill48162
Bill48162
in reply to henukit

Thanks henukit. Have you received any direct treatment for your two mets? By that I mean a bisphosphonate agent, etc. Thanks for your reply.

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henukit
henukit
in reply to Bill48162

Not yet. Just finished 6 chemos, waiting out to take MRI and blood tests. MO does not plan CT scan yet. I asked about 11-Choline but apparently it's not covered in my setting yet and MO thinks it's not needed yet. Go figure.

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henukit
henukit
in reply to Bill48162

Here we go, pulled out from there:

AE1/AE3: Focally positive

CAM5.2: Positive

PSAP: Weakly focally positive

PSA: Weakly focally positive

These findings are highly suggestive of diagnosis of metastatic prostatic

adenocarcinoma.

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BigM62

I had multiple lyric leasions on my spine. Largest at T12 was what spurred my PCa diagnosis as I had sudden nerve pain. Biopsy confirmed but showed normal run of the mill prostate cancer. Nothing unusual despite my relatively low PSA of 11 which didn’t quite compute for how advanced my tumor burden was. I ended up with a cytoplasty at T12 to remove the pressure so that I was able to leave the hospital and start treatment. From there I had 10 rounds of doxetacel. At the end my PSA was 0 and extensive Mets no longer visible on scans. Just the cement in my back still visible. I am 6 months out and PSA still zero. Spine specialist said no remaining instability and I’m in heavy physical therapy to carefully strengthen my back.

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Bill48162
Bill48162
in reply to BigM62

BigM62 thanks for the reply. If i'm reading your reply correctly, you had "bone cement injected into your vertebrates? Thank you.

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BigM62
BigM62
in reply to Bill48162

They did an RFI frequency ablation to shrink it a bit (effect same as radiation, but in an emergency a bit faster). Then they injected some cement for stability. Not really a treatment, but got it shrunk and spine stable so I could leave the hospital and start chemo.

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gourd_dancer

I certainly understand your concern about spinal column compression. It was my biggest fear and why I underwent six months of chemotherapy. Fortunately for me T2 and L3 mets were resolved and I had new bone growth. Five years ago I had a twisting fall and cracked T2. I am fine today. My point is that even with new bone growth the vertebrae affected were still weak.

I go to the gym three times a week with a Personal Trainer who keeps me away from heavy weights and concentrates on replacing fat with muscle. I saw the weight training part of your post and wanted to throw out a caution. Keep kicking the bastard.

Gourd Dancer

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Hidden
Hidden

Hi there,

Any updates on your lytic vertebrae findings? All of my vertebrae metastasis are lytic, which is extremely rare from PCa, waiting for the biopsy results taken from T8 .

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