My MRI of the spine showed numerous T1 hypointense T2 hyperintense lesions throughout thoracic and lumbar vertebra. The T8 (Thoracic spine bone #8) has the largest lesion.
Biopsy report:
"NO EVIDENCE OF CARCINOMA SEEN.
NOTE: Sections show two core fragments of bone with intramedullary hemorrhage and reactive changes (hemorrhage and crush artifact procedure-related). The marrow space is markedly hypocellular with stromal cells, as well as rare bone marrow elements also present. No clusters of malignant epithelial cells are identified (initial and deeper levels examined)."
So, this is certainly good news of no "prostate cancer" findings in the spine. Interesting enough, the Medical Oncologist (MO), reads report, no cancer here and punts!
Will follow up with the Dana-Farber team and find someone with bone expertise.
Anyone there took a biopsy of the spine with negative for cancer result? My research in this area is going into endless loops...
It does sound painful, a needle into the spine, yikes. But was not fearful, because I've passed kidney stones - 3 different times so far, a women friend once told me, she rather have natural birth of triplets, than pass on kidney stone again.
No pain with the biopsy at all, the worst pain was the hospital not letting me go for 3 hours after the procedure.
"Sedation start time 12:15 p.m.
Sedation end time 1:18 p.m.
Versed dose 4 mg I.V.
Fentanyl dose 100 mg. I.V.
The skin is prepared and draped in aseptic fashion with 2%
chlorhexidine scrub. The skin and subcutaneous tissues are
infiltrated with 1% Xylocaine local anesthetic.
The target lesion is the T8 vertebral body..
Fine-needle aspiration biopsies are obtained using 13 gauge trocar
needle with coaxial core biopsy system. Core biopsy and fine needle
My bones are riddled with many mets, especially spine and they all show up in CT scans. I have had 4 x PsMa gallium68 PET and CT scans which shows where PsMA is generated by Pca.
I am 71, Psa is about 25, I had ADT, and two lots of RT to PG since diagnosis Gleason 9 in 2009.
I don't know the significance of your MRI scans and I don't understand the medical terms that you quote in the MRI report.
It seems you have bone lesions, but they are not caused by Pca.
So as Tall A says, maybe arthritis, old age. But to get better idea of Pca status, we would need to know your Psa, age, history.
Despite having many bone mets, I cycled 82km this am at 23.3kph average, and no bone pains. But a friend had a bone met that suddenly gave him pain within a hip joint, so he became bedridden in hospital and another met caused a bowel blockage and he is not yet 60, and Pca was diagnosed only 3 years ago, so from what I see happen to other men shows that Pca causes different troubles for different men and treatment has different effects and the overall survival is different.
I have my No 2 Lu177 infusion next Friday, and maybe is stops Pca progressing for awhile, but it is too early to be able to know what results of treatment will be.
Life is still good, but it could change to bad at any time.
Age 58, no prior health issues, active lifestyle. Diagnosed 09/11/2018, PCa Stage 4, PSA 1000+, my symptoms of weak urine stream, burning sensation and incontinence prompted a urologist visit and consequently dx of above.
Pelvic/Prostate MRI depicts extensive area metastasis, large tumors extending prostate and pressing the bladder, soft tissue area tumors and enlarged nearby lymph nodes.
Treatment track: Casodex, then 2 weeks afterwards Eligard 6 month dose, followed in two weeks with Zytiga. After one month from initial treatment PSA 62, then after another month PSA 0.5 (approx 2.5 months of treatments), obviously hormone sensitive at the moment.
So, the spine MRI lit up with lytic and blastic lesions, not typical from PCa. And then the negative for malignant cells results, my thinking, could this be a case of possible Stage 3 treatment strategy?
Well if Psa was 1,000 and ADT has reduced it to 0.5, then you had a large amount of Pca at diagnosis. ADT does not reduce the amount, it just puts the cancer into a kind of coma where it grows slowly, and thus produces a small amount of Psa. But this situation will not last, and Psa will probably rise in weeks or months ahead.
If I were you I'd get PsMa scan which would show if your bone mets were PsMa avid, ie, show whether bone mets are in fact caused by Pca.
Google "Theranostic treatment for Pca"
I'm having Lu177 no 2 on next Friday. I have a lot of Pca, but fairly low Psa of 25 now. But without ADT and RT and chemo so far, I would have died in 2014.
Someone here mentioned successful immume therapy they had in US somewhere. I think you are in deep trouble with Pca and you need the best doctors and treatments.
Live in the Boston, MA area, Dana-Farber is part of my current Oncologist (2nd opinion) team.
At Dx, PCa was a raging fire, at least got symptoms of weak urine stream and incontinence because of tumor invading bladder wall - got me noticed quicker!
Your PSMA PET/CT suggestion was spot on (pun intended), also considering using Foundation One for sequencing analysis.
You, were diagnosed a while back and kept your docs on the edge, this is what I need to do, will catch up on your posts. The PSA debate does not seem based on scientific evidence, but the following link is revealing:
There is immune therapy I mentioned before being trialled at 5 places in USA with advanced patients getting 2 drugs, ipilimumab and nivolumab,
and I quote from text about "Checkmate650" trial from a link provided by someone else......
" If you have an advanced stage of prostate cancer (stage III and IV), it means the disease has spread outside the prostate gland. Doctors can treat this type of cancer, but they can’t cure it.
At its highest, Ralph’s PSA level, a measure of prostate cancer, was over 500. Right now, it’s not detectable, the sign of a possible cure.
“There is a solution for a lot of people,” Austine said.
The two drugs have already gained FDA approval for advanced kidney cancer and metastatic lung cancer. The Checkmate 650 trial is ongoing at five centers across the U.S. including the University of Chicago."
Ralph is 85, and Austine is his wife, and there is a picture of them both.....
I will inquire if anything is done like this in Australia because if Lu177 does not work, or gives me very little lifetime extension, I will try to get whatever else might work.
bboby gave the initial report here, and I quote the URL to winknews report here:-
To get into a clinical trial, you need to be referred by a doctor to the trial; nobody can just email the ppl running the trial and be accepted.
What wink news does not have is follow-up on happy-happy medical stories. I do not know what % of men get a fix from the immune therapy described.
Provenge is another immune therapy that was developed about 10 years ago and it soon got FDA approval after claims for life extension of 12mths, but latwer that was revised to 4mths. Cost was $140,000 today's dough. The company giving it had $$$$ troubles, someone else bought it out and claimed they knew how to get more success, but I have not heard much. One man emailed me to say the 4mth life enjoyed 9 years so far with extremely low Psa, ie, he was in early patients, so the expense was OK. This man said life extension had been wrongly calculated. So unless you could view a review of all Provenge patients you just cannot know what the outcome might be; so all treatment is a gamble.
Oscar Wilde said "A man can lose a lot on a woman, but a lot more on a horse"....
And he may have added, " but a lot-lot more on a doctor or a lawyer..."
And to get my Lu177 treatment, I had to have a referral letter sent from my oncologist to the doctor giving me Lu177. I happened to think Lu177 was my best hope from the time before chemo last July, but I did at least try Docetaxel, and for just long enough to have my doc agreeing with me it was not working. For any Pca treatment to appear to be working which is shown by a reduction of Psa. In some cases a " Psa flare" is seen soon after beginning a treatment, and my Psa went from 12 to 36 in a few weeks, then it went to 26, 27, 40, 42, but never down to less than 12 before I began chemo. So I read up about chemo outcomes and maybe you get max mean benefit of 20mths life extension with low flare, but if flare is +400%, then max life extension was 8 months. I had flare of +300% so I figured I was not going to get much life extension.
One might say the flare is the Beast Roaring at you and your doctors.
But I have seen a man have Psa go from 40 to 2 in 3 chemos, and that looked good, and there was no Psa flare. It was the only chemical that had appeared to work. Alas, soon after, and despite having 10 chemos over 30 weeks, his Psa went right back up.
He lost all hair, fingernails and toenails, but he's about your age and he played competition tennis, walked his dog, was active, ate right etc.
He's in trouble right now. He didn't mention the neuropathy that affects nerves in legs, feet hands, but he must have had all those like I got from only 5 chemos over 15 weeks.
Please I have scored all here, my life is in balance, like you and you have survived at moment. I'm here open to all to see our correspondence, it is my interest from your experience.
I have never regretted being open, and I thought by just being here that if i posted to a few good men, and some excellent women, people might benefit, and I may definitely benefit. I have read hundreds of postings and stories on Pca since well before I got diagnosed in 2009; Two or more online forums existed in 2007, 2008 similar to this one, but they both disappeared, and they were not archived, so that accumulated information ceased to be a well of knowledge. It seemed these groups had been started by IT savvy men who probably had Pca, but as they lost their grip on life, maintenance of the websites fell apart and it appeared the sites became riddled with viruses, and nobody could keep them clean, so they became unusable. But by 2008, I knew much about what I feared might happen to me. I still fear, but have no fear of fear itself, because if we did not fear what endangers us we would crash too soon, and I'd always prefer later, or not at all.
Riding a bicycle keeps me frightened, stressed, always watching for a motorist who does not see me, seeing gravel, mud, sand, a dog or wayard pedestrian etc. I know I need the worry and stress to survive, and to enjoy wonderment and humour, but of course I'd be the first to say I wish the Pca would just go away.
I'll be absent for next 3 days while I get injected with minature Atomic Bombs in the form of radioactive Lutetium that gives off alpha particles to gatecrash the Pca parties going on all around my body.
So much appreciate you taking the time to respond, I'm a PCa newbie, but energised motivated to learn and contribute. To be honest, I'm anticipating my castration resistance and just being a warrior...
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