CT or PET scan: Hi, I am really... - Advanced Prostate...

Advanced Prostate Cancer

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CT or PET scan



I am really confused and worried. My dad did bone scan 2 weeks ago and there were 2- 3 spots in his ribs. He did CT urogramm and everything was fine. oncologist told my dad to do CT scan of the chest without contrast. urologist is for Pet scan.I don’t understand why the oncologist think it should be a fracture, injury, inflammation and urologist thinkS there are Mets. My question is how can the cancer travel into the ribs if everything is fine around the prostate? can he do only PEts an and skip the CT or he need to do both of them? My dad feels very good except some hot flaches due to the firmagon. The urologist want to switch with Eligard very 6 months and oncologist every 3 months. Really confused..... I appreciate any advice from you. Thank and have a nice day.

15 Replies

It is usually a PET/CT, so both combined. When there are metastases in the bones, the cancer has traveled through the blood. If is near the prostate it has traveled via the lymphatic system and did affect lymph nodes. You can have bone mets and no affected lymph nodes or these are too small yet to be detected.

Zot1 in reply to GP24

Thanks a lot.

Cancer is a strange beast that defies expectations. Mine is aggressive and very adept at metastasizing. The left side of my prostate is virtually cancer free, while many of my bones are affected.

Zot1 in reply to tom67inMA

Thank you so much!

A bone scan only detects sites of bone remodeling. Bone remodeling happens when bone is broken or irritated by things like metastases or arthritis. There are two ways to tell if they are metastases or bone irritation - (1) if they shrink when given hormone therapy, they are metastases or (2) biopsy of bone tissue.

Metastatic cells spread through the blood, so they can show up anywhere. Prostate cancer prefers lymph nodes or bones at first.

1 month, 3 month or 6 month shots are a matter of patient convenience. Your father should choose.

He should be under the care of an oncologist - the urologist's job is over.

Thank you so much! I really appreciate the way you answered all my concern. When my dad did CT urogramm everything was fine including lymph nodes that are close to prostate. Is there any possibility that bones are not affected ?. The doctor said 2-3 spots in ribs. Urologist gave him the second injection today, fortunately after 40 days of the first one. Very disappointed even I was told hormone is still working after 28 days. Merci

Please request a PET/Axumin scan. This will light up every area with mets, soft tissue and bone. This can be followed by a whole-body bone scan using technetium-99m, a nuclear material that collects in areas of metastasis in the bones.

Now, having suggested this, please consider: how old is your father and does he have any other medical issues? Because the results of the above two scans may be actionable, but with with treatments that have side effects that must be taken into account.

Tall_Allen is spot-on...it's time for you to have your father under the care of an oncologist who specializes in urologic oncology.

Blessings to you and your father.

Zot1 in reply to tallguy2

Thank you so much. My question is, If the CT of the chest is fine for the spot , does he need to do PET scan. Why the urologist give him CT ABdominal, thé oncologist CT scan for chest instead of giving him CT scan full body to detect met. Can multiple IMR replace them ? My dad is 76 no medical issues, 0 pills in his life, very active person. It was a choc for us ......

Stage 4 here. I ditched my urologist when my cancer was diagnosed, the oncologist is here to treat your cancer, that’s his or her specialty. I do monthly blood panels with Xgeva and eligard shots. PSA is at <0.05. This of course is after chemo. I have 2 scans every 6 months as follow ups , ct with contrast and full body bone scan. Can’t be to careful with the monster

pilot52 in reply to larry_dammit

Good Advice.....I was treated at MD Anderson for head and neck and my current PC. Flew to Duke over a year ago to check them out because really easy trip with N40JB.. I did discover a novel antidote ...Both facilities are aware of each other and it seems the oncologist (being of a competitive nature really take time and outline my treatment. ) I really think this is human nature because I treated some professional athletes when I was in practice knowing well that they were seen elsewhere during the year...Even here in my home town the local OC who has nothing to do with my treatment but sees me for a Lupron shot if that is all I am getting is very receptive....my babble is complete ...I like multiple brains because I am afraid I would end up with a brain with an ego larger than his judgement...Blue Skies ,

Bobcat64 in reply to pilot52

Was the treatment assigned the same at both hospitals?

Zot1 in reply to Bobcat64

No, in different hospitals.

6357axbz in reply to Zot1

Did the different hospitals recommend the same treatment, or different

Zot1 in reply to 6357axbz

Different treatment, different hospitals, The urologist and oncologist are in different hospitals. Thank you

pilot52 in reply to Bobcat64

Yes it was....when I went castrate resistant the OC at Duke wanted to add Xtandi, MD Anderson concurred . When this fails I will get both opinions and make a decision..I like Houston for long term care

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