How do I know?

[RockinSidney]

My PC metastasized to bones. It's been over a year since any scans. T is below 1.8 and PSA = 0.05, but how can I be sure if cancer is in remission?

[Tall_Allen]

Remission means that there is no evidence of disease progression, so you are in remission. It does not mean that you are cured.

[tango65]

You know because the PSA is very low and stable and you only been in ADT plus apalutamide. Besides your cancer does express PSA since your PSA a diagnosis was over 100.

[Benkaymel]

I'm no expert, but even though your PSA is staying very low, I would have thought you would be given another scan by now if it's been over a year. Bone mets could be progressing while PSA stays low. Can you feel the mets? Do they feel like they're changing at all (for better or worse)?

I have a few large mets on my ribs, pubic ramus and spine and although I've been on Prostap (Lupron) for nearly 4 months and my PSA dropped from 13 to 0.99, it feels like the mets are getting slightly more painful.

[SteveTheJ in reply to Benkaymel]

FWIW, I could never feel mine.

[Benkaymel in reply to SteveTheJ]

Good to hear. Hope it stays that way for you.

[NecessarilySo]

You might tell by the intensity of pain. The question is whether the cancer cells or tumors are reducing in size or increasing in size. Pain is evoked by growth. There is no pain when cancer cells are reducing, because the mets place no pressure on nerves.. There is a continuous war going on inside your body, between the metastases and your immune system, T-cells or killer cells. If the immune system is winning, no pain. If the mets are winning, you can feel it. Lupron brings met growth to near zero, but that tiny T value means that the mets are able to grow at a near unnoticeable rate. You alone can sense the pain and whether it is there or not. I f you apply a treatment therapy that works, you alone can sense loss of pain. Example: a headache stops when there is no pain.

[SteveTheJ]

You can't be sure. My latest bone scan shows nothing, like there was never anything there. But as always it's just a point in time. Therapy continues and I certainly hope the cancer goes to sleep forever but there's no way to know.

Best wishes.