Ductal Adenocarcinoma and PSA - Advanced Prostate...

Advanced Prostate Cancer
10,590 members12,633 posts

Ductal Adenocarcinoma and PSA

leach234
leach234

I was diagnosed with prostate cancer in March (PSA 5.2 )and had laparoscopic prostatectomy in April. Prior to surgery a full body bone scan and CAT scan of abdomen were done and were negative. Pathology showed 2 tumors. An Acinar adenocarcinoma Gleason 3+4 fully contained and a Ductal Adenocarcinoma Gleason 8 with small focal margin on prostate <2mm. Fat taken around Ductal tumor was negative for cancer. Pathology wast pT2. PSA tests at 2, 3, and 7 months have all been <0.02 which is lowest level local lab can read.

I read that PSA is not always a good indicator to determine metastasis when one has a Ductal Adenocarcinoma as the cancer cells give off very little prostate specific antigen.. Should I be getting annual bone scans and CAT scans to confirm cancer isn't spreading? How does one monitor Ductal variety of prostate cancer? Anyone have experience with this?

4 Replies
oldestnewest

I agree that PSA is a poor indicator of progression with ductal. PET/CT may be more useful for monitoring treatment success than a bone scan/CT. I don't know if other biomarkers (bone ALP, PAP) are more useful than PSA.

j-o-h-n
j-o-h-n
in reply to Tall_Allen

Two geniuses.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 12/11/2018 9:37 PM EST

Not to be crass--but welcome to the Ductal Club--if there was a membership I would be close to being the first on this site.

Joking Aside---> Ductal, is rarely present at 100%. Since you read your Pathology Report I knew that there would be 2 Pathology elements--and you describe 2. The Acinar, will give off the PSA Antigen, And to the best of my knowledge so does the Ductal, until such time as the Ductal Cells reach a Nadir--hard to define by any test--and then by Molecular Biological Change, lose their AR' s and Morph into another species for lack of a better term--but still cancer. These then do not give off a PSA, some are defined as Neuroendrocrine Pca cells--and the best way to monitor, is by our latest Pet Scans, to pick up Mets, usually from the Prostate Bed, and Bone--lymph Nodes could also be a rich environment for them.

So PSA counts, Alk. Phos. Test Counts, Can monitor for NEPca. with Chromogranin A Blood Tests--but I think they would be negative at your stage. And to be aware of any unusual pain that you think might be bone.

If IMO your PSA reaches 0.12-0.15--an Auximin Pet Scan would be appropriate--only about 25% of the time at this PSA level can this scan detect Mets---but it is covered by Medicare, and Insurances--as per policy,

Nalakrats

j-o-h-n
j-o-h-n
in reply to Nalakrats

Two geniuses.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 12/11/2018 9:37 PM EST

You may also like...