How can a blood test result in a unexpected appointment with the specialist? What to expect

[FormulaRob]

I apologize as this shouldn’t be a post, I should just wait for tomorrow to find out but anxiety is part of who I am

Father(65 years old) -226 PSA months ago

Bone scan and CT Scan complete Early September. - no bone spread or organ spread. Some swollen lymph nodes just outside prostate

Biopsy scheduled for Nov 3rd

blood test 1 week ago Saturday October 15th (4 vials of blood) and now Friday October 21st they have called him in to talk for tomorrow (Monday October 24th)

If the scans were good , why the sudden unexpected appointment tomorrow ?! They wouldn’t say over the phone but if the scans were good a month ago then what could a blood test see that could cause urgency ?! Just an increased PSA? If that’s the case then I believe the scans were more important although those were a month ago

I don’t even know what I’m asking here other than what the hell can we expect..

[Hidden]

Its good they are paying attention.

[FormulaRob in reply to Hidden]

that part is comforting at least despite us asking for quicker action for 2 months straight lol.. but if this is just to speed up treatment then I’d be happy. I’m just worried some unexpected bad news coming tomorrow

[Tall_Allen]

Did Andrew Loblaw respond? Probably, they want to start you on medicines, which is a good idea.

[FormulaRob in reply to Tall_Allen]

Hi Allen, no response from him although he was on vacation when I had sent a few emails so likely bad timing. We got in touch with another specialist although who interpreted the scans and said the CT scan and bone scan look like a good prognosis. Just need to wait on the biopsy. This specialist also knows the doctor currently working with my dad so he reached out to him for us which was nice

[WillowHawk]

Hi. Just sending love. it is said some huge percentage of what we worry about - is it 90%- never comes to pass. Just try not to worry until you have the facts. Difficult I know. Is it pretty out? Try to do nice things when this happens. Maybe too late except you could burn a candle, watch something funny, or just be cozy. Try not to bury your worry in things that aren't helpful like hot fudge sundaes etc. Thinking of you! xo. Kate

[FormulaRob in reply to WillowHawk]

Thanks Kate as always you’re friends and family are so lucky to have you , you’re awake there giving good vibes❤️ Just worked for a few hours now to get a head start on Monday and now I’m going to relax .. maybe even breakout some raspberry chocolate ice cream haha . Have a good night !

[FormulaRob]

whoops you are right .. my mind a little scrambled. I was thinking possibly ADT as well due to an increased PSA. I’ve been researching and can’t see any other reason. We’ll see how much it has increased while these doctors made us wait 3 months

[tango65]

It is imposssible to know why they want to talk with him tomorrow.

If they did a Comprehensive metabolic panel , one possibility is that they found an increased alkaline phosphatase (ALP) an enzyme which could come from the liver or the bones and other tissues.

In the context of PC an elevated ALP could be a concern about bone metastases, particularly in a patient with a PSA of 226.

Bone scan and CT scan have a low sensitivity to detect metastases including bone metastases. There are more sensitive tests such as PSMA PET/CT or the Axumin PET/CT.

[FormulaRob]

Oh wow that really sucks I thought we were in the clear in terms of spread after the bone scan and CT scan. Fingers crossed it has not spread to his bones this all sucks so much

I was thinking maybe his PSA was high (226) because the tumour is almost completely blocking his ability to pee. I’ve read the larger the tumour then the higher the PSA can be so not necessarily an indicator of cancer development

[FormulaRob]

Most definitely. His PSA which was 226 three months ago has climbed to 286.

The doctor called him in because my father was recorded talking to the receptionist multiple times over the phone and was expressing his concern and maybe his .. opinion on how they leave him the dark for months at a time.

So they called him in only to apologize and bring him to speed on where they see things at this time.. which is 226 to 286 PSA which the specialist I’m not concerned about apparently since the cat scan and bone scan show he is pretty clean .. other than a 1cm cancerous tumour on one side of the prostate plus some swollen lymph nodes around the pelvic area which may or may not be cancer.

Biopsy still scheduled for Nov 3rd with appointment to discuss results plus treatment on Nov 23rd as biopsy results take about 2 weeks he said. Specialist predicts 2-3 weeks of hormone treatment followed by radiation although can’t be certain until biopsy results are in

Red cell count /white cell count are perfect apparently .. does not have an elevated ALP number .. it’s pretty crazy considering the high PSA number but it seems as if PSA isn’t always going to tell you the whole story

Still worried of course and we really don’t know what the future holds. Just taking it one step at a time and praying for the best

[WillowHawk]

Thanks for update! I have a Dr appointment too on 11/3. Will be watching for your next news. Look at all you are learning w your research. You’ve come a long way from day 1. Hugs.

[FormulaRob in reply to WillowHawk]

anytime Willow I don’t have much knowledge on any of this but I will share whatever I can through this experience to maybe help others. I hope your appointment coming up goes well Kate . Hope you had a great weekend and feel free to reach out if you need to talk. Much love ❤️