Second full body scan 2+ yrs later

[arete1105]

CLINICAL HISTORY: Reason: eval metastasis from prostate cancer

CREAT 1.15 03/04/2021 GFR 61 03/04/2021

COMPARISON: NM; Bone Scan

1/16/2020; NM; NMBONWB

5/30/2018CT; CTAPC

12/26/2019

RADIOPHARMACEUTICALS: 21.0 mCi of TC99M MDP was given on 5/20/2021

8:10:00 AM by route: INTRAVENOUS RIGHT ANTECUBITAL

TECHNIQUE: Images of the skeleton were obtained in anterior and

posterior projections at 2 hours using a large field-of-view gamma

camera and whole-body scanning table.

FINDINGS:

again seen is subtle small focal radionuclide uptake in the left side

of T12, stable /unchanged since 5/2018, and corresponding to

sclerotic lesion on CT,likely a bone island,although a stable focal

sclerotic mets cannot be exclude.rec clin correl.

The bone scan demonstrates a normal distribution of tracer throughout

remainder of the skeleton. Both kidneys and urinary bladder were

visualized normally.

IMPRESSION:

again seen is subtle small focal radionuclide uptake in the left side

of T12, stable /unchanged since 5/2018, and corresponding to

sclerotic lesion on CT,likely a bone island,although a stable focal

sclerotic mets cannot be exclude.rec clin correl.

o/w normal bone scan.

This report electronically signed by Dr. John Nguyen, MD on 5/26/2021

9:43 AM

What I am reading is in 2 yrs+, there has been no increase of cancer. The second scan was basically the same as the scan 2+ years earlier. Cancer cell were subcentimeter in size.

My PSA during this period ranged between 4-6, and T ranged between 14-6. I did cut back on sugar but didn't go fanatic over it. I have been getting the Lupron shot only. I attribute the arrested growth of cancer to my supplements as the PSA# should have shown cancer growth.

Also according to the AMA people, if the PSA is that high during a 2+ yr period, the Onclogists automatically assume the cancer is growing. The second scan showed that higher PSA doesn't support that premise, given other variables.

[Tall_Allen]

Congratulations on your indolent PC, but I am LOL@ "I attribute the arrested growth of cancer to my supplements as the PSA# should have shown cancer growth." You don't suppose Lupron had anything to do with it?

[arete1105 in reply to Tall_Allen]

I am not denying the effect of Lupron, but Lupron is supposed to slow down the growth of cancer via a low PSA level. But when I take Lupron, and the PSA is up and the cancer growth is stalled, then I have to assume something else is keeping the cancer down. Isn't that how the theory goes?

[Tall_Allen in reply to arete1105]

Lupron slows down the growth of PC because it prevents activation of the androgen receptor by testosterone. PSA is a product of the size of metastases. Your stable PSA (4-6) tells me exactly the same story as your bone scan - the Lupron is preventing the size of your metastases from growing.

[arete1105 in reply to Tall_Allen]

I basically agree with you. My point is, if 4-6 PSA can indicate a stabilized cancer growth, then why is everyone on this blog aiming for PSA<.1 and thinking that is a good level. No one would have though my 4-6 level was "good" until the scan said so. Prior to the scan everyone with 4-6 would have said their "hail marys" and genuflected every opportunity they had. My oncologist told me 4-6 was too high and he aimed to get it lower.

[Tall_Allen in reply to arete1105]

I have no idea who this "everyone" is you've been listening to. Lower has a better prognosis than higher, but PSADT is even more prognostic - so your PSA stability, demonstrating indolence and reinforced by stable radiographic findings is what really counts.

[Schwah in reply to arete1105]

Rather than supplements, why aren’t you adding Taxotere and or Zytega which have been proven to extend progression and survival substantially over Lupron alone?

Schwah

[arete1105 in reply to Schwah]

My supplments are "touted" to have anti cancer properties. If my second scan says no cancer progress, why change my program?

[Schwah in reply to arete1105]

Because numerous double blind phase 3 trials have shown adding these other drugs early to Lupron, will double your time to castrates resistance, your time to increased mets and your survival vs Lupron alone. We always knew that Lupron would extend all those things and that is what you are experiencing. But why wouldn’t you add those things if you know it will will likely extend your life. Especially Zytega which will add little side affects to the Lupron.

Schwah

[2dee]

My two comparative scans look to me like about 2/3 of mets are really reduced. Lupron and Alkaline Therapy. Started Xtandi a year ago but no scan since.2Dee

2 scans with dates shown

[Runner4000]

I personally agree with Tall_Allen. My PSA has been pretty flat at under .5, which I attribute solely to my Lupron injections rather than the various vitamins I take. However, if the supplements seem to help you and don't hurt, I see no reason to object. What are the supplements you feel are beneficial?

[arete1105 in reply to Runner4000]

You make my point- everyone aims for <1, which means the cancer growth is at the slowest rate, but the cancer is still growing. I am interested in stopping the growth of cancer, which the scans show. If <1 is slowly growing, then my 4-6 rates should be galloping down the road. But it has stopped. So then I need to look for a reason other than Lupron. I am looking at my anti cancer supplements.

[Runner4000]

My understanding is that the effect of Lupron is quite variable in different individuals. For many, it can temporarily keep the the PSA at the lowest level and then slow future growth; in others, it can have the effect of maintaining low PSA levels for quite a long time. Hopefully that is the case with you AND with me!