Advice needed on bone trauma

[Tonyliv]

My skeleton is riddled with bone cancer, but since diagnosis December ’17 docetaxel, abiraterone and last Christmas, targeted radiotherapy on my prostate have kept things in check.

However, two months ago I fell and badly bruised my left ribs, still twinging even now. The subsequent bone trauma increased my alps from 146 to 196 on my last blood test (also used to measure cancer activity). My PSA, having dropped for months, also turned the corner and went up from 0.07 to 0.09.

I’m probably being over cautious and it could be a blip. My oncologist has suggested a CT scan in a couple of months, but I’d like the wisdom of this site.

Could the fall have “kick started” the dormant cancer into becoming more aggressive? Should I request an MRI too? If a scan shows increased activity, can it be targeted? Any advice appreciated.

[Tonyliv]

Thanks Nalakrats 👏

[cesces]

What kind of scan would detect "Ductal, Intraductal, Cribriform, or Undifferentiated Cancer"?

[PSA680]

Sorry to hear about your fall - fingers crossed the PSA & ALP just a blip

[Tonyliv in reply to PSA680]

Cheers PSA680. I see we’re both from the North West. From your profile I see you still suffer the painful monthly firmagon shots. After 6 months I switched to a 12 weekly triptorelin injection. Much easier. 👌

[PSA680 in reply to Tonyliv]

Yes North west lads - discussed with my oncologist last month - he’d like me to stay on Firmagon if possible as my blood numbers are great - he’s put me on Dexamethasone before next injection & asked me to take an antihistamine- next monthly injection tomorrow so fingers crossed - thanks for the advice though very much appreciated- pls let me know how you get on

[Leader4077 in reply to Tonyliv]

I switched from monthly Firmagon to daily Orgovyxx tablets-way easier, same results. Mike

[GeorgeGlass in reply to Leader4077]

did you achieve the same nadir?

[Leader4077 in reply to GeorgeGlass]

Got down to 3.0 PSA on June 11…….after 7 consecutive PSA drops on Orgovyxx and the chemo Docetaxel for 6 cycles, PSA was up yesterday to 3.4

[cesces]

What about an fdg scan?

Do you know what PSA level it requires?

[bean1008]

Just throwing this out there but the rib injury and ongoing pain could possibly be costochondritis?

[Tonyliv in reply to bean1008]

I love the knowledge on this site!.Thanks for another perspective. No sharp pain; just the odd throb and pangs, heading towards 3 months now. Hopefully, it’ll settle down and subside slowly. 🤞

[bean1008 in reply to Tonyliv]

Same with me Tony…dull pain just above my heart. Gave me a scare and went to the ER…diagnosis was costochondritis.

[wagscure259 in reply to Tonyliv]

Sorry to hear of your fall and trauma. Costchondritis is generally felt at the area where the rib attaches to the sternum (breast bone) as it is an inflammation of the joint which is cartilaginous and treated with anti-inflammatory medication along with ice packs to the offending joint or joints. Usually just pressing on the joint at the breast bone will reproduce symptoms. TA’s recommendations for a bone strengthening agent or Xofigo are highly recommended. Best wishes

[Tall_Allen]

You should not be using an ultrasensitive test to measure PSA. There is nothing you would do differently because of it and random fluctuations are anxiety-provoking. Bone ALP will certainly go up as your ribs repair themselves.

Are you taking a bone strengthening agent (Zometa or Xgeva)?

Have you discussed Xofigo?

[Tonyliv in reply to Tall_Allen]

No Tall Allen. I’ll certainly bring those up with the oncologist. Appreciated. 👍

[Hidden]

Which scans specifically are you referring to Nal?

[Sam1962]

I suspect the Oncologist can answer your question on whether trauma from a fall can activate dormant cancer. I think it’s unlikely.

There is no downside to having additional diagnostic tests. If it gives you peace of mind then have the MRI.

If your oncologist has made the right treatment decisions so far (which it sounds like), then you can trust his guidance now.

I believe in an “aggressive smart” strategy with treatment decisions as there are treatments that will cause more harm then good but without the facts you cannot make an informed decision.

[lincolnj8]

I get Zometta infusions to strengthen my bones. Down to 2 times a year. Was 4 times a year in the beginning

[bravovictor]

What is ALP ?

[bravovictor]

What is ALPS ?