Undetectable PSA with bone lesions?

[BarronS]

Just wondering if anyone has had undetectable PSA with some lesions. Or stable disease with a low PSA. My fathers PSA is currently less than 0.02. He was taken to the hospital the other day due to a nasty reaction to an infusion of Reclast.

At the hospital I requested another CT scan and xrays, along with another PSA test. The CT scan showed stable lymph nodes with a persistent osseous lesion on his t10 vert. Another one is on his sacrum. All of this is unchanged from his last CT scan 2 months ago. PSA is again less than 0.02.

So im just wondering if anyone else has had an undetectable PSA with bone lesions or "stable" disease. I'm trying to get him to get those spots radiated.

Advice. Opinions. Stories.

[tango65]

I believe his lesions were present before the treatment started. They do not disappear in CT or mri studies even when PSA goes down with the treatment. They could have changes that could be detected using MRI. It is important they are not bigger than before treatment and the diseae is stable.

pubs.rsna.org/doi/full/10.1...

[BarronS in reply to tango65]

Wow. Very helpful study. I think you are right. These were most likely present before initiation of therapy and they remain. Also interesting to read that it is difficult for imaging to gauge the effectiveness of therapy for prior bone mets.

It's comforting, in a strange way, to know that he is not unique in this and that it doesn't mean that he has nero end or is castrate resistant. Thanks for linking me to such a helpful study.

[tom67inMA]

My PSA just went undetectable and my bone scan shows much less activity. The MO didn't do another CT scan because it wouldn't differentiate between live tumors and dead tumors if I understood his explanation correctly.

[Hidden in reply to tom67inMA]

Live Mets v dead Mets. A very good MO and RO can tell. New bone growth will replace the dead Mets and that is how they can tell......

GD

[NPfisherman]

Some here have reported smaller lesions or lesions gone but usually that has been over time....Celebrate his "undetectable" / low status and give it some time for the meds to work on lesions.... Enjoy the great news....

Fish

[Garbonzeaux]

Ditto. Had a few bone mets at diagnosis 2 yrs ago. Have been undetectable for 15 months after Lupron, taxotere and RP. The bone lesions are still faintly visible in Tc99m bone scans. So his lesions were likely also there before treatment.

[Hidden]

Until he has some type of systemic treatment, the Mets will continue to grow and spread. They have to be killed. Starving will not work; just slow the disease progress. Of course he may be of the age, where he is likely to die from something else than metastatic prostate cancer.... keep kicking the bastard.

GD

[BarronS in reply to Hidden]

Thank you for the reply. He is on systemic treatment. He's on lupron and zytiga. Has been for a little over 7 months.

[NurseRatched]

Yes, my husband developed new lesions and his PSA is 0.01. It was his bone pain that caused our onc to do scans; only then did he realize what was going on. At disease diagnosis, my husband’s PSA was only 15 and he had at least 2 dozen lesions. So perhaps some men simply do not produce a lot of PSA.

[Faithful7 in reply to NurseRatched]

Hello NurseRatched,

We just got a sad MRI report this morning. It seems my brother’s lesion grew bigger on L3-L4.He has been on Zytiga for 10 months. His PSA is still undetectable but he started having bone pain and muscle weakness.How was your husband’s new lesion managed?

Thanks for your feedback.

[NurseRatched in reply to Faithful7]

My husband probably has 50 lesions. Once Zytiga and Xtandi failed, he did 2 cycles of chemo. Now we are hoping to get overseas for Lu-177 therapy. My best to your brother!!!

[Faithful7 in reply to NurseRatched]

Thank you very much

[RonL]

I’ve been on Zytiga for the last two and a half years with half a dozen mets. My PSA has been undetectable for a little less than two years. I became metastatic prior to going on Zytiga.