Bone scan necessary ?

[Muffin2019]

Recently I had bladder issues, burning when peeing and urgency. I went to see my GP and found no uti but scribed flomax which had really helped. The last psa is 6.4 up from 4.1 in may, I am having a amdomen,pelvic CT scan next tuesday with contrast which I can see as necessary. Last scan was january that was a good scan with no disease progression. He has ordered a full bone scan, I have have no pain and the mets there showed a healing. Why a bone scan when the problem is in the pelvic/bladder area ?

[Tall_Allen]

It is a bone scan and a CT scan. It will tell you if any metastases have grown in size and number. The CT will also show sites of non-bone tumors.

[Muffin2019 in reply to Tall_Allen]

I imagine the lupron is not as effective after 2 years so he may add something. Hopefully all is well and the lupron is just not as effective.

[pjoshea13]

Cancer aside, if "burning when peeing" is due to an infection cranberry juice is as good as anything. High in anthocyanins.

CranMax is a good product (without the sugar). Many brands sell it. e,g,:

swansonvitamins.com/swanson...

There are also some PCa cell studies.

-Patrick

[Muffin2019 in reply to pjoshea13]

I will look into it but they found no bacteria in the urine.

[Muffin2019 in reply to pjoshea13]

When do you take it, at night or morning, the worse is in the morning.

[j-o-h-n in reply to Muffin2019]

You can get the cranberry in pill form (which I take - especially with my Thanksgiving turkey dinner).

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 08/09/2020 2:51 PM DST

[Currumpaw in reply to pjoshea13]

Hey pjoshea13!

Good call! "THEY" have been recommending cranberry juice for many generations with good results.

The old remedy may lower inflammation and in turn PSA.

Currumpaw

[Hidden]

You can ask your doctor why, but your doctor probably ordered the scans because your PSA is rising and it makes sense to check for progression to see if the current treatments are working. Bone and CT scan is standard procedure for that purpose.

[Muffin2019 in reply to Hidden]

Thank you, I have read where lupron had a 2 year run.

[Hidden in reply to Muffin2019]

2 years on Lupron alone is a good run for someone who is diagnosed at stage 4 with a PSA over 100. If you get 18 months or more it's a good sign for success with a second-line ADT drug such a Zytiga or Xtandi added. I waited a little longer with my PSA, but if yours keeps rising, your doctor will most likely recommend adding the second-line ADT drug.

[Muffin2019 in reply to Hidden]

What is your take on casodex, I know it is not the newest but it has hardly no side effects and is cheap, my thought is ride with that until it poops out then go to the generic of zytiga . I might get a year or more out of it with the lupron with it.

[Hidden in reply to Muffin2019]

You could try it, you just have to be careful because it eventually becomes an agonist and feeds the cancer. So that means you watch your PSA closely and get off it quickly when it starts going up. Your PSA might go down after you stop. Also make sure to keep checking those liver enzymes because Casodex can also make them go up, it think it's roughly as common as with Zytiga. The risk is described as "small but significant" and early monitoring is the most important (3-4 months) followed by periodic monitoring. Best to discuss all of this with your doctor.

[CalBear74 in reply to Muffin2019]

I have been on Lupron for eight years and I am not yet resistant. The two-year number is used by doctors to warn patients and may not be relevant to any specific patient. I am a Gleason 8, 78 years old, and going strong. I am not taking any other drugs for the past four years. My first Urologist had me on Casodex also Until we moved to Florida

[Muffin2019 in reply to CalBear74]

Why did you stop the cosadex ?

[CalBear74 in reply to Muffin2019]

Muffin, My Florida urologist did not believe there was any incremental value FOR ME to casodex after four years.

[Hidden in reply to CalBear74]

Did you have local treatment with prostatectomy? Guys in that category seem to go the longest before castrate resistance. The ones diagnosed at stage 4 with significant mets are lucky to go 18 months to 2 years.

[CalBear74 in reply to Hidden]

Gregg,

I have had no surgery or radiation. In 2012 my urologist felt those therapies would be pointless for a stage 4 patient because of the evidence of Two mets to the pelvic bones. So he started me immediately on Casodex and Eligard, the latter being a Lupron twin as you know. This regimen continued until fall 2016 when we moved from Scottsdale to Tampa. My new urologist dropped the Casodex and prescribed Lupron. I added a medical oncologist to my care team and he continued the mono therapy.

I should point out in 2015 I began IP6 in accord with Dr. Shamsuddin’s recommendations in his book. I am still using IP6. After using it 6-8 weeks in Phoenix I was in for a periodic exam. It had caused my PSA to drop thereby triggering my Doctor To insist on a DRE. He failed to detect any nodules; this clearly rattled him and he spoke to me about it. I wouldn’t tell him about the IP6 because he had sneered at supplements. Six months later I told him

For more information see my past posts.

[Muffin2019 in reply to Hidden]

I still have the prostate not that I need it while on ADT.

[AlanMeyer]

Pain and urgency in urination can be due to kidney stones. If you have some, the tamsulosin/Flomax may be all you need to relax the urethra enough for you to pass them while urinating. If so, that can give you tremendous and lasting relief. If the problem does not go away in a few days you may want to see a specialist, probably a urologist, who can check your urine for "crystals", which are possible evidence of a kidney stone. There are drugs stronger than Flomax, and other treatments, that can be used to resolve the problem. The CT scan may also reveal tiny dark spots in the kidneys or urinary tract that may well be kidney stones rather than metastases.

If the pain has not stopped completely, I suggest urinating into a jar or bottle so that you can see what's coming out and take it to a doctor if necessary. You might see blood clots or lumps if there are kidney stones. You'll also want to drink lots of water and maybe cut back on coffee for a while.

Best of luck.

Alan

[Muffin2019 in reply to AlanMeyer]

Thanks, I had one cup of coffee this morning after a year of not having it. The worst problem is in the morning when I wake up or a bowel movement. The bladder feels sore, having CT scan Tuesday, will mention the crystals to him. The oncologist is checking the kidney to check on the cyst in the kidney. I am drinking more water, talking cranberry pills.

[V10fanatic in reply to AlanMeyer]

Ding, ding, ding! I suffered through kidney stones for the last year or so. It hurt like hell when I peed.

[Muffin2019 in reply to V10fanatic]

How did they diagnose them, ct scan ? Did they give you meds for them ? How did you finally get rid of them and what dietary changes did you make ?

[V10fanatic in reply to Muffin2019]

You can get KUB X-Ray(cheapest). Mine also showed up on both my Axumin and PSMA PET scans. I was already on Silodosin so no need for meds. It took 3 surgeries to get rid of them all. Take them seriously, besides being very painful they can get lodged in your Ureter and become infected. I developed Sepis because of this, and needed an emergency surgery. In respect to dietary changes there are list on line concerning foods to avoid, and you need to be drinking an extra 2 liters of water a day.

[Hidden]

Muffin, I am not giving you treatment advice; however, because of query about the necessity of bone scan and your statement, “ Had no bone pain at all, the spots are encapsulated and no soft tissue involvement“, I would be remiss if I did not share. 2004 with two spinal mets and a PSA that rise from a 6.8 to a 32.3 in less than year after primary treatment with a Gleason 7(4+3)....... well in the next six years I had 24 nuclear bone scans and soft tissue CT scans ( always paired together). I had one more set in 2016.

Bone pain from cancer is not what you want. Please stay on top of your disease. I know that my bone mets were killed and have been replaced by new bone growth. I also know that soft tissue is clear of disease. I don’t understand encapsulated unless you mean the holes left by the cancer have filled in with grown new bone, ok.

Do what you have to do, but I would not rely on bone pain as an indicator.

GD