Can PC spread to nerves with a negative PSMA scan?

[tasseo]

I've told my TULSA history previously. Had TULSA ablation of 70% of prostate in 2019, G=7a and clean MRI afterward for 4 years. Last year MRI found new tumor, and biospy G 3+4 with PNI .....but only 5% of 2 cores were G4. Prostate size 10ml and PSA=1.2 Doctor did a PSMA in December and found nothing. I was told to consider IMRT or SBRT without hormones. But I must first operate/correct a urinary stricture before any radiation therapy.

Recently, I have had recurring nerve "tinkeling" and light pain in upper legs and calves. Muscles are tight and stressed. Doctor did an ultrasound of pelvis plus blood tests and found no explanation. What is the likelihood of cancer spread along the nerves that cannot be not detected by any scan?

And what is the recommended treatment if indeed the PNI has invaded the nerves? Thanks!

[Tall_Allen]

Cancer can migrate through nerves, but it isn't likely that it has spread already.

[tasseo in reply to Tall_Allen]

Thanks for your reply. Do you think seeing a neurologist to check it out is a good idea? That is, if it is even possible to confirm the spread along nerves?.

My oncologist suggests starting hormone therapy now before radiation is a good idea.

[Tall_Allen in reply to tasseo]

It is impossible to find because microscopic, if it exists at all.

[GrnPndr]

Just an opinion as a medical professional. Consider the possibility of lumbar spine neuropathy