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Bone Scan and CT scan

DaveRN94
Posts: 13
Joined: Oct 2011

Had some good news for a change :>) The urologist left a message on our home phone telling me that the bone scan and CT scan were negative and clean, no problems. My question is what does than mean. I know it is good news, but what exactely does it mean? Is it more evidence that the cancer is contained within the prostate, the lymph nodes and so on?

Thanks for your clarification.

mrspjd
Posts: 688
Joined: Apr 2010

Hi Dave,

It is good news. However, since CT and bone scan cannot identify sub-microscopic PCa cells, be aware that results for CT and bone scans are usually negative unless disease is very advanced.

Based on the info in your other thread/posts (Gleason 8, etc), I would encourage you to obtain a 2nd opinion pathology report on your biopsy core specimens from a path lab that specializes in analyzing PCa cells, such as Johns-Hopkins. Here’s a link with more info: http://csn.cancer.org/node/212732

Usually the 2nd opinion path report will either confirm or downgrade (worse) your initial biopsy path report (Gleason, %'s, etc.) from your local lab. Once you have this info, it can be helpful in determining whether add’l diagnostic tests might be useful to assess if there is any local spread. Those tests might include an EMRI (Tesla 3) and/or a color doppler ultrasound which may (or may not) indicate possible ECE to seminal vesicles and/or local lymph nodes. All together the info may help you and your medical team determine a more accurate clinical staging which, in turn, may play a role in deciding on the best option(s) to treat your PCa.

Hope this helps.

mrs pjd

VascodaGama's picture
VascodaGama
Posts: 1511
Joined: Nov 2010

Dave

I am late but let me wish you a Happy Birthday. Enjoy your 70th and the new “decade”

The negative image studies (bone scan and CT) are not rare in guys with low PSA. NCCN guidelines recommend them only for patients with PSAs above 10. Nevertheless, the negative results diagnose your case as localized to which your doctor’s treatment choice for Seeds plus IMRT has high probabilities of success.
(http://csn.cancer.org/node/230506)

Those tests, however, cannot assure that your case is contained. As Mrs PJD comments, the information from the biopsy (clinical stage) and from higher resolution scans such as EMRI (Tesla 3) or a color doppler ultrasound may provide a better picture of your real diagnosis.

Gleason 8 sets you in the high risk group for possible recurrence and the grade of 4 is for an aggressive type of cancer. Radiation in combination with hormonal therapy has shown to improve the results of the treatment. However, HT will influence the “real” PSA which may be the reason why your radiologist do not want to administer it as neoadjuvant. Nevertheless, you can always request for inclusion of HT in the protocol starting it when your PSA reaches its nadir.

I wish you peace of mind.

VGama

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