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hypermetabolic lymph nodes in chest

Posts: 3
Joined: Oct 2013

my husband has been watching his PSA slowly rise for the last fifteen years, when it reached 13 in 2011 he got one posetive bit from a biopsy gleason of 6. we were encouraged to watch and wait no big deal. In June 2013 PSA went to 14 so we had another biopsy four positive bites gleason of 7. We did bone scan and mri and we were told possable spread some small lesions seen in hip and spine but not sure.  Now we were getting two different opinions so we calledStanford hospital for another opinion they said get a petf18. When we got the results this is what it said....Osteoblastic metastatic bone lesions involving L2 and L3 vertebral bodies on pelvis.  AND Hypermetabolic mediastinal and bilateral hilar lymph nodes consistant with metastatic adenopathy. Reactive hyperplastic a consideration

Our home town tumor board said not sure if it has spread. Started hormones Sept 9. Took a trip to Stanford hospital oncoligist uroligy doc said stage 4 prostate cancer probably spread to lymph nodes. Our home town uroligest says he doesnt think so because his PSA wasnt that high and the spread to his bones is not even a for sure thing. The lymph nodes were 1-1.2 cm and SUV 7-8.2. 1-7-cm lesion was slightly enlarged on his hip from a year ago.

Does any one have any insight or experiance with such conflicting diagnosis. How uncommon is it to spread to the chest lymph nodes. We are trying to stay positive but this one seems confusing. HELP new pet scan on Dec. 6

Posts: 351
Joined: Jan 2011


I had a urologist tell me about the same thing. He was wrong.  I would suggest that you believe Stanford.  Secondly you need an Oncologist.  This is not a game.  Your husband needs to jump on this because his life depends on it.  

Mypros state cancer spread to my lungs as soon as it hit my prostate.  My urologist would not consider this.  Finally had to go to emergency, on my own, and get x ray then ct scan to confirm my suspicion. Urologist did a CYA and I never talked with him again.

Please get your husband to Oncologist ASAP.

Radiation works beat when things are small.  The larger it gets the harder it becomes.


Posts: 3
Joined: Oct 2013

Thank you so much for replying. Our small town tumor board has a radiation oncologist on it, they are the ones that said they dont think its stage four. We keep reading posts but they never talk about it spreading to chest lymph nodes. I asked the uroligist if he had any patients that it had spread to these lymph nodes, he said yes but only when it was more wide spread in the bones and further advanced. I would like to thijk Stanford is wrong but I guess I know better.

What was your gleason and PSA?  How long had you had the diagnosis before you found out it had spread? Did you have any symptoms? I so would appreciate any info from you or anyone

Posts: 351
Joined: Jan 2011

I started with the VA, GLEASON 6.  Switched to Onc urologist, after surgery Gleason 8.  They did x-rays at beginning and they showed a single nodule in lung.  Onc never bothered to read report. I switched to an oncologist specializing in metastic prostate cancer.

My single nodule was joined by four more.  They were small and the radiation killed them.

The prostate cancer came on in six months. It had spread to my seminal vessells, nerves, bladder, and lungs.

PI had a radiation oncologist named Dr. Kerch.  He had been going around country installing "cyber knife,  or radiosurgery" machines. He was only one allowed to do install and training in the US.  We had a chat at the end when the results were in.  We talked about. Life expectations and he said five years would be pushing it.  At least it gives you time to plan.  My case is really different from most people so do not judge by me.

Prostate cancer is usually slow growing, but that is not written in stone.

I do not understand why they did notradiate the bones where it had spread to.  What are they waiting for?

Is there a higher authority you can talk with?   If it is in lymph nodeI, it is in his body.  Delay is not good, in my opinion.


Posts: 21
Joined: Aug 2009

Have not posted in quite a while, but felt compelled reading your info.  My husband was Gleason 9, stage 3b, with positive margins, peri neural invasion.  Nearly two years after RP and radiation, hormone treatment, a routine chest X-ray at work showed problem area which was later biopsied as adenocarcinoma of the prostate.  Surprised his doctors and us!  Started on Casodex, continued HT.  3 years later, there are multiple bone and lung metastases, even after taxotere, Zytiga, xtand.  If I can give advice, be a strong advocate, don't stay with doctors who are hung up on staging a disease which does everything it can to spread!  Seek out all the info you can, be forceful in dealing with your husband's medical staff, and get treatment!

Rakendra's picture
Posts: 99
Joined: Apr 2013

A very important post.  My best wishes to you and your husband.  This post needs to be read and understood by all.  It demonstrates that the very people who we are placing out trust and our lives in their care are often not paying atention, often interested more in their bank account than our well being, and, unfortunately, are just plain incompetent.  My experience with urologists and especially pathologists has been a disaster over and over again.  I now go to my Internist who I trust and in the case of needing another opinion, I will now travel to the best available, even if out of the Philippines.

   When we are stressed and in danger, we want to rely on our trusted medical friends.  If you do this without double checking everything always, you ARE risking your life.  Love, Swami Rakendra

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