While there is limited distension of the urinary bladder, there is thickening and irregular stranding involving the anterior urinary bladder wall. Additionally, focal intense fluciclovine uptake is noted within the wall. This was not appreciated on the August 6, 2020 PET-CT scan.
This was from Axumin scan
What was the interpretation of the radiologists reading the PET/CT? If there is intense (SUV?) accumulation of the tracer in the bladder wall it could indicate an extension of the cancer into the bladder. False positives have been described with the Axumin scan.
IMPRESSION
1. Suspicious, new, fluciclovine uptake in the gravity independent, anterior urinary bladder wall. Urinary bladder evaluation is recommended.
2. Persistent lytic focus a mildly increased radiotracer activity in the right lateral 3rd rib, suspicious for osseous metastatic disease. Greatly improved, fluciclovine uptake in the left iliac crest, likely representing successfully treated metastasis.
3. No new suspicious radiotracer uptake in the prostate or axial/appendicular skeleton.
4. Multiple sclerotic foci without significant metabolic activity, likely representing treated disease.
The radiologists did not make the call the finding is an extension of the cancer. They want an evaluation by the urologist. The urologist will do a cystoscopy and possibly a biopsy to determine what is going on. Fluciclovine is not an specific PC tracer. It could be uptaked by other tissues.
ajronline.org/doi/10.2214/A...
Ok does it detect bladder cancer though
Like no prostate bladder cancer
I just don’t uNdetsyand if the Zytiga and lupron is working cause it seems in bones and now that but I have read in other reports that he has mild diffuse thinking like 5 years ago on MRI
Oh ges this is so scary I’mFreaking out
Benign conditions could also uptake fluciclovine. The bladder examination will resolve this situation. It could be a post radiation cystitis.
"Several benign conditions can demonstrate increased 18F-fluciclovine uptake, leading to false-positive findings (48). Benign prostatic hypertrophy, acute and chronic inflammation (including postradiation inflammation), and infection all demonstrate varying levels of 18F-fluciclovine uptake. Reactive lymph nodes with uptake have been described adjacent to vascular grafts. Cutaneous and musculoskeletal inflammation has variable activity."
ncbi.nlm.nih.gov/pmc/articl...
Even if it would be prostate cancer there is that still treatable - Zytiga and lupron is first tx since biochemicalReoccurrence and psa . 19
For what my opinion is worth, with stable PSA and not major PC radiographic changes, an extension of the PC into the bladder seems unlikely. Late radiation cystitis may develop years after the radiation treatment.
Ok hopefully that is what it is - he always had the diffuse wall thinking even in 2015 MRI of pelvis when he started his radiation-
Lab tests and scans always generate a lot of anxiety. I wish you the best of luck.
Thank you so much for ur help I feel better - I just pray everything is ok- it’s just so scary when they release results and you don’t have anyone working on the weekend to help relieve anxiety
So if something like that would be prostate extension is it possible that he would stillBe able to be treated and also would they just change meds
Wait until the urologist sees him. Nobody knows if this is PC or any other kind of cancer.
He will see his MO who specializes in prostate
Chris, quit worrying yourself to death about your dad. You don’t know and neither does anyone in this group. It’s what happens when one gets an early report. Do what is recommended. Have your dad see his Uroligist with the report. Have your dad’s Medical Oncologist go over the report. Have your dad’s Radiation Oncologist go over the report. His team are pros, you are not.
Case in point, I once had a doctor worry me to death about a scan. When I got to the right doctor and he reviewed and ran a test, he had the answer. I asked what he found, his reply was a piece of shit.
Good luck
GD
needed the laugh!!
I had the same on one CT Scan two plus years ago. Was cancer on the bladder inner wall. Doc did a TURP and removed the inner wall cancer and been good to go since then.
Was it prostate cancer or bladder cancer
Stage 4 Prostate Cancer. Had spread to illium, sacrium (sp) and one spot on L11 plus the upper bladder wall.
2 years almost now on Xtandi and Lupron. 5 years total. PSA down to .21 as of two weeks ago. High was 80.08 in Oct 2016.
Did u have to get a cystoscope fromUrology to check it out
Have had 3 cystoscopies total. Plus 2 MRI's, 3 CT scans and 3 ultrasounds, plus 1 bons scan. Have a great team of docs all working together to keep me going. And that is the key, a great team of docs.
So his pet scan showed uptake on bladder so his MO sent himTo urology is that common to do or would they just handle it
Generally one would expect the Urologist to get involved. They specialize in bladder, etc. so they would do the cystoscopy and see what was happening, plus check out the prostate, etc.
So even if it was prostate cancer to the bladder that would involve urology
Yes
I’mSorry I am
So
Confused- so when they thought urs metastasised to
The bladder the medicinal oncologist didn’t handle that they sent u for cystoscope to verify from
Ur urologist
In my case, the urologist found it first. He did a cystoscopy for a bladder stone the size of a golf ball. Caught it then. Then went in and lasered the stone, and TURPed the prostate.
My MO would not do that type of procedure. She watches the cancer overall and prescribes the medications as needed. But she listens to me and the Urologist and acts as needed.
Other MO's might do a cystoscopy IF they specialize in prostate cancer, but would believe that most would refer back to the urologist otherwise.
Yes and I don’t think our MO thinks it’s prostate cancer Bc everything was going in the right direction and clearing up! I just hope it is not a primary bladder cancer.
What did they do on ur bladder to get rid of it
Went in with a "knife" and cut it out of bladder wall. Warning....do not look up device used to cut it out. It scares the hell out of you, knowing that it is being put up your peepee hole.
We all are scared to death.....It's worse when we're scared "to shit"....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 08/29/2021 12:11 PM DST
Great to see your wise-ass posts again, you are the best!
Thank you sir.........Now if women would only call me the beast.... oops best......
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 08/29/2021 6:12 PM DST
The best or the beast , either way you get respect!😂
Bad News. Would appreciate input. 
PSA results. Does this mean anything?
What do these results mean
PSMA and bladder Cancer?
It’s back and I’m scared to death!
