PC spreading

[Prostate_1234]

First post, recently diagnosed with PC, Gleason 8, with two 7's. Robotic surgery planned for 12/23, recently had upper back pain and a burning sensation that comes and go in my hip. Can anyone share early symptoms if it's spreading to bones. If it's spreads to bone, should surgery be the next step or radiation?

[Tall_Allen]

You should not have any therapy before you've had a bone scan/CT.

[LearnAll]

Should first get bone scan/CT/MRI to know full and exact diagnosis. No surgery prior to that.

[Fairwind]

What Alan and Learn said....What is your currant PSA?

[Prostate_1234 in reply to Fairwind]

Current PSA 4.86

[rscic]

Much depends on what your PSA is now. Possible imaging includes MRI + Bone Scan + CT + possible Axumin PET + possible PSMA (largely depends on what your PSA number is .... below a certain point PSMA is not likely to show anything--PSMA testing is "experimental" in the USA but there are at least 7 sites that will do it if your post-surgical PSA is high enough). I had G7 (3+4) + G6 in 11 of 14 biopsy samples. I had an MRI of the prostate before biopsy. With the number of positives on biopsy I had surgery. At surgery there were no positive lymph nodes, there was minimal extra prostatic extension + 2 small areas of positive margins. After surgery I had CT + repeat MRI + Bone Scan + Axumin Pet Scan before getting Radiation Therapy. My PSA was too low to get a PSMA. Axumin study was done on the off-chance that some disease focus might show up in or around the prostatic bed. CT + Bone Scan + Axumin Pet Scan were negative. MRI showed an enhancing area in the left iliac wing which may have represented a benign vascular malformation .... to be sure the area in the left iliac wing was treated with radiation as well as the pelvis and the right & left iliac node chains. I am now on PSA watch every 12 weeks for the next year ... I will have a discussion with Medical Oncologist then as long as PSA stays below 0.1 in the meantime. That's my story & I'm sticking to it.

[rscic]

A pre-procedural PSA of 4.86 suggests this was found early & may be curable. I suggest you consider consulting a University Urologist who has familiarity with all the newer methods of treatment (Laser, High Frequency Ultrasound as well as standard surgery or radiation treatment/seeds). If your disease is confined to one area of the prostate it may be more easily treated with one of the newer methods. You will likely also get Bone Scan + CT and/or MRI and possibly Axumin Pet Imaging to be as sure as you can this has not spread beyond the prostate. If you chose surgery much of this imaging might be done after the surgery IF there is evidence of possible spread beyond the prostate.

[larry_dammit]

Felt like I had a broken rib when I tried to take a deep breath, pain in my upper back, weakness in the legs, Sound like you need to ditch the urologist and talk to a medical oncologist, scans before surgery, if the cancer has went Mets already don’t mess with removing the prostate,to late. Just saying. 40 months and counting. 🙏🙏🙏

[Hidden]

Nuclear bone scans and soft tissue CT scans. Had a baseline done by Urologist immediately after diagnosis in 2003. Month later another set for the Radiation Oncologist before seeds it compare. Another set three months later for a second RO before IMRT. Another set by each RO six months later. Metastatic. A new set by Medical Oncologist before chemo trial. Then another sixteen set of scans over the next six years. Finally the last set in November 2016. In all told 24 sets of scans since original diagnosis of PCa. It is how progression or regression is marked.

The point is that every step of the way scans are taken to compare to the original baseline set of scans.

Good luck.

GD

[Hidden]

Don't be in such a rush. Remember that your doctor will always recommend the treatment that he is familiar with. Do your due diligence and know what other treatment options are available to you. This is a slow moving disease.

[jmb23]

You need to go to an oncologist that specializes in prostate cancer not just an oncologist. I made that mistake myself. If at all possible, go to a center of excellence for a second opinion. As was mentioned, you need a bone scan!!!

[GeorgesCalvez]

Hi there,

It is easy to get sucked into the I have cancer and a pain in the leg, back, etc, etc, hence I have metastases scenario.

With your Gleason Score and PSA level it is possible but unlikely.

Demand a scan as quickly as possible before your RP and then you will have an idea.

If the scan comes back negative you may have metastases but they are likely too small to cause any pain eg it is something else.

Best wishes,

Georges

[Prostate_1234 in reply to GeorgesCalvez]

Thank you, all of you guys. Appreciate the support. God Bless

[j-o-h-n]

Give us more info: Your -Age, Location, Treatment center(s), Doctor's name(s)... All info is voluntary but helps us help you and helps us too. Thank you...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 12/09/2019 10:33 PM EST

[Prostate_1234 in reply to j-o-h-n]

53, now using UT Southwest Medical center Dallas, TX, going to MD Andersen for a 2nd opinion. Also did blood work recently every test they ran was normal. Is there anything in your blood work that's an indicator that the cancer is getting worse?? Cancer was all on the right side 3 tumors .1CM -14% cancer, .15CM - 13%, and .5CM - 45%. With 3 out of 12 cores is that likely to spread outside the prostate or continue to spread in the prostate? That's my question for my urologist.

[j-o-h-n]

Thank you for your reply. You may want to add that data on your home page under your User Id for future use and reference by you and our members.

Worse is not the way to describe it... "spreading" it better way. Usually we use our PSA score to determine the cancer's velocity. You're a young guy so there are many ways to battle the beast. Please do not panic.... we have all been there... If it's to the bones (which I doubt) then radiation is probably best. Otherwise your choice with your doctor's advice is for a RPD. A few of our members refer to that as "removing the mother ship"... There are consequences to either method so read up and be aware... Make sure you have a good Medical Oncologist that specializes in Pca. I wish I could answer all of your concerns but I chose to be a Chippendale dancer instead of a doctor. BTW an important number from your RPD is your Gleason score. Do your Kegel exercises, they will help you later on..... Keep posting here and you're going to have a hell of a holiday beginning 12/23. BTW I had a RPD and two hernia repaired on a Friday and was out of the Hospital Sunday morning. The Foley you have to wear is really annoying.... but they take it out in 5 to 7 days (if I recall correctly, cause I can't remember shit).... so -

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/15/2019 5:53 PM EST