Enlarged Lymph Nodes on MRI and CT

[Blue1320]

Hello, new to this. Never posted before, hoping for some insight. Gleason 7 (4+3) PSA 6. Bone scan clear but lymphadenopathy in groin nodes (inguinal; iliac nodes). Does this mean spread? Being sent for a PET Scan Friday.

[Tall_Allen]

The inguinal node is the troubling one. It will require intensive hormone therapy. They can irradiate the nodes, but radiation will not be curative. Please write back when you get the PET results.

[Blue1320 in reply to Tall_Allen]

thank you for the quick response. Is it usual to have Gleason 7 and extensive spread?

[Tall_Allen in reply to Blue1320]

Bipsies are only a random sampling. Metastases may be seen if pattern 4 or 5 is in the prostate.

[Blue1320 in reply to Tall_Allen]

Do you know if there are any other reasoning for node enlargement that is not indicative of spread?

[Tall_Allen in reply to Blue1320]

Disease may cause node enlargement. But you wrote that it was confirmed with "lymphatomy."

[Blue1320 in reply to Tall_Allen]

Wow. I just rechecked and it states ' Bilateral inguinal and external iliac lymphadenopathy, concerning for metastatic disease.. ' I did not realize the spelling and the difference that means. Thank you for your input, it's really appreciated. I do not know much and my daughter is helping me try to understand what she can.

[Tall_Allen in reply to Blue1320]

The PET scan should be informative, then.

[cesanon in reply to Blue1320]

I swear TA is more knowledgeable than most specialists. Maybe almost all specialists.

[Xavier10]

First off, I am not a doctor and TallAllen knows a lot more than me or really any of us in here. So this is just my personal "two cents" from my experiences and research.

lymphadenopathy can mean spread but I was once told the inguinal node was an unlikely area for prostate cancer. After my radiation and ADT I took a Choline scan (I asked, my RO said sure, if you want one...they did it, probably shouldn't have because it was too soon after all that...but I digress) and my inguinal node showed uptake and he told me not to worry about it. I also had uptake in my humerus. I also had a Medical Oncologist take a look and he said "probably you are just an inflammatory kind of guy." End quote. These scans can be finicky and can show inflammation or infection.

However, I did not have swollen nodes, as you do. Or any other evidence of cancer from traditional imaging. And it is true that swollen nodes can be from other things. And again, this was a choline scan, which Mayo used to do more than they do now. The PSMA scan is with a protein that is much more likely to show up with prostate cancer. But even with that there can be false positives and false negatives. I believe if they see uptake they are likely to do a biopsy, which of course, will decide it once and for all.

So while I don't want you to have too much hope, there is a possibility it can be something else. Hence the word "concerning." Let us know what the PSMA scan says. Also let us know if it is not a PSMA PET scan.

[Blue1320 in reply to Xavier10]

Xaviero10, thank you for putting the time and effort in responding. Any insignt is overly helpful. I've been doing copeous amounts of research since my urologist from Kaiser takes over 4 weeks to see and hardly gives any information. I feel completely in the dark when I get these test results. Luckily I am supposed to see him Monday - hopefully with more insightful info on my case. One of the emails mentioned a PSMA pet due to findings on CT so I assume that is what is going to be done Friday. From what I find online it is unusual for Inguinal nodes to be involved and can hardly find any info or case studies on it. Again thank you for your input, it really means a lot to be able to talk to someone rather than just read case studies and surf the internet. I hope all is well with you on your own journey.

[cesanon in reply to Blue1320]

So what happened?

[Blue1320 in reply to cesanon]

hi, still have not recieved the results. Scan done Friday.

[Blue1320]

hello, thought I was give an update and see if anyone has any thoughts. Finally got PSMA scan result stating: mild tracer activity in the left prostate. No positive regional or distant metastasis. However, there is non-tracer avid axillary, iliac, obaturator, and ingunial lymphadenopathy concerning for secondary malignancy.

WTF