Lower PSA but rib mets pain

[ZCorn]

I was diagnosed with PSA 289 in mid January 2019 with 2 mets on my right ribs, my right iliac and possibly on lymph node in pelvis. I got Lupron shot Feb 5th and began Zytiga/Prednisone about end of March. I also tightened diet from vegetarian with cheese, bread and carbs [pasta & potatoes] to vegan, leafy organic greens, nuts and some organic fruit for diet but no potatoes or bread etc.. I take Curcumin, and calcium supplements. I lost 20-22 lbs., exercise lightly and am aiming to reduce stress [easier said than done].

My PSA scores have come down as follows

PSA, 289.8 01/10/2019

PSA, 8.8 03/05/2019

PSA, 2.6 03/15/2019

PSA, 0.8 03/29/2019

PSA, 0.4 04/12/2019

PSA, 0.2 05/10/2019

QUESTION: The last couple of weeks I've had more stress than normal. Beginning Sunday 5/12 my ribs feel like they're acting up again, yet the PSA test taken 5/10, two days before the tenderness in my ribs, shows PSA down. Any ideas?

NOTE: Based on the Curcumin exchange on here a bit ago, I removed the Curcumin from my morning supplements for the 4 days prior to the last PSA test but not prior to any others.

[BarronS]

PSA looks great. I would request a PET/CT scan or the axumin scan if available to see if the mets on your ribs have disappeared. If not, I would request them to get zapped with SBRT radiation.

Don't just accept a bone scan. Bone scans have low specificity and sensitivity. Just from the experience with my father, research articles, and people on here - bone scans are absolute junk when it comes to low PSA.

[ZCorn in reply to BarronS]

Thx!

[tom67inMA in reply to ZCorn]

I've had pain in ribs and hip since diagnosis, though it finally seems to be improving now. Stress will make the pain worse. My PSA was at 0.02 at last check and my bone scan was much improved, but still showed some activity where I have pain.

My thoughts: bones hurt when cancer is living in them, when cancer is dying in them, and when they're healing afterwards. Nerve damage can contribute to the pain. Bone scans are good enough if you have a crapload of mets. Imaging in general is a good complement to PSA because occasionally people have reported new or growing mets despite low PSA.

[ZCorn in reply to tom67inMA]

Thx tom.

[Break60 in reply to ZCorn]

Your Psa is too low for axumin scan to be effective. It needs to be near 2.0

[nobaday]

BaronS reply is good. If pain is present for a few weeks and not due to tax pain, the ex wife or some other activity DO A CT SCAN. This will show if these Mets in ribs are stable or not. Stereotactic radiation could be the ideal treatment.

My neck met at C3 has grown in low PSA environment and I’m heading for stereotactic radiation in June.

[Bebby1 in reply to nobaday]

Ask for a PET scan

Very accurate

[ZCorn in reply to Bebby1]

Thx nobaday & Bebby.

[Kaliber in reply to Bebby1]

I asked for a PET scan.... my budget minded onc doc told me to buy a turtle !! rattt ta tat

[Break60]

Why not talk to a RO about SBRT to your rib mets?

[2dee]

My random bone pain from extensive metastasis to whole skeleton still around randomly well after a year with what feels like an occasional spike. Research couldn't really confirm why. PSA below <2 after 1300+ start.

I treat the pain every 6hrs mostly with daily 100mg CBD drops to push the pain wayyyy back and motor on. Continuing to develop MY diet so I don't feed cancer.

2Dee

[JimVanHorn]

I started with PCa in 2007 with 42 radiations, then in 2011 a bone scan showed metastases on hip area stage 4 and I started Lupron with 30 more radiations. I stayed on Lupron (Eligard - generic) for 6 1/2 years I stopped therapy 1 year ago and my doctor called me on Christmas Eve and told me I no longer have cancer. For pain at night with my doctor's permission I took Tylenol generic 650 mg 8 hour timed release which is OTC at drug stores and not habit forming. It did not react with other drugs I was taking. It does not remove all pain just enough to get to sleep and stay asleep. I think CBD oil should work fine, but I would tell my doctor. It never helps to keep something from your doctors we only go through cancer therapy once or maybe twice successfully. So just keep asking questions and just keep truckin'.

[ZCorn in reply to JimVanHorn]

Wow, great story. Thx Jim.