Update on "How credible is my report"

[Birdwood]

Finally got an explanation as to why my DCFPyl PET scan was reported as radical prostatectomy and not a prior RT . My GP called the radiology lab (in my presence) and got another Radiologist to review the scans. He confirmed the 4 'uptakes' and said he could understand the initial radiologist interpretation in that the prostate was small and charred with no uptake [charred is my memory of the description]. On reviewing the historic correspondence, my GP said he saw my initial treatment was called 'radical radiation therapy' and assumes the radiologist "misread". Not entirely convinced with the explanation but happy it was reviewed by a 2nd radiologist.

Am curious as to how there could be no uptake in the prostate but were 4 nodes in the iliac region, 8 years after the RT/ADT treatment.

[NewMan57]

Hi,Good to hear you had a review and explanation of what might have happened.

Re the no uptake in prostate but present in lymph nodes. It is possible that the cancer had already begun to infiltrate the perineural or lymphovascular pathways. So RT to prostate was successful but there was already some cellular level spread.

Regards

John

[Tall_Allen]

I'm glad you got that straightened out. You are generous to let it go. Radiation doesn't leave the prostate charred, and prostatectomy doesn't leave any prostate at all.

Maybe this graph can help answer you question. It is just pro forma but it illustrates the point that it can take many years for the first metastases to become visible. (# of metastases detected is the y axis)

First few metastases can take years to become detectable

[Birdwood in reply to Tall_Allen]

Fully appreciate I could have had the radiologist reprimanded but decided it was best to extract as much info as possible (catch more bees with honey than vinegar). However did report the incident to the Cancer Council of Victoria. Will go into more detail with the RO in a couple of months. Re graph: not looking forward to year 10

Thanks again your input.