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Advanced Prostate Cancer
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It is possible to have low PSA and bone mets?

I had RP in July 2018 (pathology was G7 and all was contained) and subsequent PSA tests have been <.03. Lately my ribs have been aching (so I immediately assume the worst), but I was under the impression that PSA would rise if bone mets developed. I will call the doctor this week, but they are very slow to respond. Is anyone aware if PSA can stay undetectable while metastasis is occurring?

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It is possible, if you are presenting Neuroendrocrine Pca. It is highly unlikely with newly diagnosed men-->July 2018. If you are on ADT---> you did not mention-->certain drugs like Casodex, has been know to cause some bone pain, along the lines of ligaments, attached to bone.

I would not suspect any Mets. Read your Pathology Report. Was there any indication, of highly undifferentiated, Pca cells in the report? Or was there any mention of Ductal Pca cells?

We all feel ghosts in the beginning. But if calling your Doctor is in your plan, then do so. You have a great PSA!

Nalakrats

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How do u know if u have neuroendocrine prostate cancer ?

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The Test, usually when you have Mets, is the Chromogranin A test--look it up on Google, and read about it. I am not sure that it works if your burden is low. There is another test, whose name I have forgot. But most of the guys on this site that tested for it, used the Chromogranin A Blood Test.

Nalakrats

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I'd say it's unlikely that you have bone mets with such a low PSA unless as Nalakrats says, you have NEPC. That's quite rare. The only way to really know is to have imaging. If you are having pain in your ribs, CT scans may show the mets there, but not the larger bones like the pelvis.

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gregg57 Why won't CT scans show mets in larger bones?

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Probably not with your pathology report, which indicates normal acinar adenocarcinoma, contained, and neg. margins. It's pretty common to attribute everything to the cancer after a diagnosis.

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Check for osteoporosis and rib fractures. Happened to me.

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I stubbed my toe once and thought it was cancer.... Every little pain you have will make you think it's cancer. Time will cure you of that.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/04/2019 6:40 PM EST

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No question that we have all had the same thought with unaccounted for aches and pains. Most of the time but not always, your PSA would go up with increased PC, especially in a new location. Give it a few days. Just know that your oncologist will not hesitate to schedule you for a scan if you have some of the basic symptoms. That is not a bad thing, they are just doing their job responsibly. PC is so slow growing, the one thing we have going for us is patience when we are not sure. Be brave, have hope, and try not to stub your toe! 😊πŸ’ͺ

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