PCa with bone met? can somebody please help/advice

Frank-1964
Frank-1964 Member Posts: 18 Member
edited August 2020 in Prostate Cancer #1

I am 56 yeras and had a PSA of 5.1 (30. may) took MRI on 11. august and TRUSP on 17. august with 4 samples taken (from suspecsious area). I live in Norway.

Unfortunately, I am realizing now that I have had almost all of the PCa symtomps starting 2019 without taking any actions.

For making the long history short here is what I've got from the hospital:

MRI: shows a little PIRADS 4 change in the right middle part. no more suspecious area in the right side.

DRE: enlargment with no cancer-suspecious changes

TRUSP (SKE0BK/KEB06K) used for taking prostate biopsy samples: no clear hypo-echogen changes. a spot in the middle part and probably a hypo-echogen area without increase in viscosity.

volume: 52

PSAD: 0.09

 

PSA taken after above examinations: 28 (17.agust)

 

I have now waiting to get the answer from histology which is expected on 3. sept.

About a week now, I have constant pain in my knees, legs, feet, hands, arms and some minor pain in shoulders and back 24/7. I have heavy night sweets. sleeping only a couple of hours and taking usual pain medicine which helps very little.

My pain do not go away and I am afraid that they have not yet evaluated the MRI results completely and they want just to calm me down til 3. september when histology results are coming.

I know, from MRI PIRADS 4, that there is high probability of clinically significant cancer, and I know that I have PCa, but what is the chance having cancer sperad to bones?

Can anyone please help me?

 

 

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Comments

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited August 2020 #2
    Bone scintigraphy
    Hi there,
    Have you had a bone scintigraphy with Technetium, that is the standard way of finding bone metastases?
    https://en.wikipedia.org/wiki/Bone_scintigraphy

    Best wishes,

    Georges
  • Frank-1964
    Frank-1964 Member Posts: 18 Member
    edited August 2020 #3
    Georges Calvez said:

    Bone scintigraphy
    Hi there,
    Have you had a bone scintigraphy with Technetium, that is the standard way of finding bone metastases?
    https://en.wikipedia.org/wiki/Bone_scintigraphy

    Best wishes,

    Georges

    TX Georges for quick respond

    TX Georges for quick respond

    unfortunately here is not so straightforward to take the bone scintigraphy. I have to be refered by hospital, so waiting and waiting.

    Frank

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    #4
    Probability
    Hi there,

    With a PSA of 28 there is some chance that you may have metastases but it is not certain by any means.
    There have been a lot of studies comparing PSA levels with the presence of bone metastases and there is a correlation between increasing PSA and their presence but it is not absolute.
    http://www.cancerjournal.net/temp/JCanResTher15839-5012356_135523.pdf

    Best wishes,

    Georges
  • Clevelandguy
    Clevelandguy Member Posts: 1,206 Member
    edited August 2020 #5
    Gleason score

    Hi Frank,

    What was the Gleason score from your biopsy?  How many cores were positive for Pca?

    Dave 3+4

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited August 2020 #6
    Waiting

    Hi Frank,

    I am sorry but you are going to have to wait, tell the doctors that you are in pain and they may speed things up a bit!

    Best wishes,

    Georges

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,346 Member
    edited August 2020 #7
    .

    Unless there is microscopic, a MRI can show extracapsular extension. Fortunately in your case this did not occur

    I wonder if you had psa's in the past. If so please indicate with dates

    There are many factors that elevate the psa, sex bike riding, a hard stool, an inflammation,  a biopsy...an enlarged prostate that lays on the urethra thus secreting more psa

    Generally at first a patient  shows nosigns of prostate cancer...I was diagnosed 12 years ago, no signs

    A pirad of 4 only indicates the likelihood of significant cancer, Gleason 7 or above.....for the most part is intermediate and very treatable

    You have not been diagnosed with PC ...so far you do not belong to our club

    even if you are diagnosed pc is for the most part it is very very slow growing 

    If you want to be proactive just in case do some research about Gleason that indicates aggressive of cancer

    Be positive go for a walk get the endorphins going

     

     

  • Frank-1964
    Frank-1964 Member Posts: 18 Member
    #8
    hopeful and optimistic said:

    .

    Unless there is microscopic, a MRI can show extracapsular extension. Fortunately in your case this did not occur

    I wonder if you had psa's in the past. If so please indicate with dates

    There are many factors that elevate the psa, sex bike riding, a hard stool, an inflammation,  a biopsy...an enlarged prostate that lays on the urethra thus secreting more psa

    Generally at first a patient  shows nosigns of prostate cancer...I was diagnosed 12 years ago, no signs

    A pirad of 4 only indicates the likelihood of significant cancer, Gleason 7 or above.....for the most part is intermediate and very treatable

    You have not been diagnosed with PC ...so far you do not belong to our club

    even if you are diagnosed pc is for the most part it is very very slow growing 

    If you want to be proactive just in case do some research about Gleason that indicates aggressive of cancer

    Be positive go for a walk get the endorphins going

     

     

    Dear hopeful and opt... I

    Dear hopeful and opt... I agree pirad 4 and gleason 7 or above most probably treatable, if the cancer has not spread in the bones. I had PSA 3 in 2017 and no test til may this year which was 5.1.

    I am not afraid of dying since I lost my daughter 25 days after she was born in 1990 and my brother on 11. june 2019. He diagnosed with colon cancer stage 4 in nov. 2017. So now is my turn. 

    I have done much research and reading about GS and will continue to do that. many thanks for your advice. I am positive but the pain in all my joints and bones, night sweets that I need to change everything every 2 hours is giving me a hard time and sometimes untolerable.

    Unfortunately there is no private hospital or medical center in Norway that can do bone scintigraphy, only public hospitals. therfore I have to wait maybe 3-4 weeks from now to take this. I am not sure how will the cancer grew with which rate, as I already in much pain. I think I am loosing a precious time and the worst is the pain.

    I appreciate your nice words and advices.

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,346 Member
    #9
    Bone scan premature

    The American Urinary Association does not recommend a bone scan for men who have a Gleason score less than 8. This is one tool among others to determine where a patient stands.

    Things have to be done in a coordinated way with excellence, not out of fear. 

    With reference to a possible bone scan; there are different types. In the usa the t99 tech scan is generally covered by medical insudance, however there is a F18 bone scan, not covered by insurance which is better

    I wonder, have you seen an internist. What does he/she say about the possible reason for your symtoms

    I attend local support group and there are men here at this site who have stage 4 cancers, who go on and on for years and years. Improvements in medical technology since scans and therapies are better nowadays with less side effects. 

     

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    #10
    Fred i sinnet

    Frank

    I agree with above survivors. You need additional tests and should wait for the pathologist’s report. For the moment you have nothing identifying cancer. The pain and hot-flashes could be a cause from a moment of anxiety. Your mind is playing tricks on you.

    In my opinion, the prostate volume of 52cc and the negative DRE justifies well the high PSA of May (5.1 ng/ml), which could be a case of hyperplasia. In fact none of the other PSA tests are valid because of inflammation caused by the biopsy on August 17 (3 days only of interval). You should repeat the PSA in two to three weeks if you want a real value. The Transrectal Ultrasound of the Prostate has limitations in identifying cancer. It is good to verify the presence of calculi. Your doctor surely is only using this image to compare with the MRI.

    I wonder if your “PSAD = 0.09” shared above signifies the calculated value of the free PSA represented in percentage. Please check because a free PSA of 0.09 % (Total divided by Free) would elevate the probability for existing cancer.

    The other shared data has nothing to do with prostate cancer. Let’s hope that the results are negative to cancer and you get peace of mind.

    Best wishes.

    VG

  • Frank-1964
    Frank-1964 Member Posts: 18 Member
    #11
    VascodaGama said:

    Fred i sinnet

    Frank

    I agree with above survivors. You need additional tests and should wait for the pathologist’s report. For the moment you have nothing identifying cancer. The pain and hot-flashes could be a cause from a moment of anxiety. Your mind is playing tricks on you.

    In my opinion, the prostate volume of 52cc and the negative DRE justifies well the high PSA of May (5.1 ng/ml), which could be a case of hyperplasia. In fact none of the other PSA tests are valid because of inflammation caused by the biopsy on August 17 (3 days only of interval). You should repeat the PSA in two to three weeks if you want a real value. The Transrectal Ultrasound of the Prostate has limitations in identifying cancer. It is good to verify the presence of calculi. Your doctor surely is only using this image to compare with the MRI.

    I wonder if your “PSAD = 0.09” shared above signifies the calculated value of the free PSA represented in percentage. Please check because a free PSA of 0.09 % (Total divided by Free) would elevate the probability for existing cancer.

    The other shared data has nothing to do with prostate cancer. Let’s hope that the results are negative to cancer and you get peace of mind.

    Best wishes.

    VG

    Tusen Takk.. (many thanks)

    Tusen Takk.. (many thanks)

     

    You are all such a great guys. I appreciate your advices and will do more to learn and study myself. Already I have learned so much from VG and hopeful and opt...

    I will go in 2-3 weeks to take a new PSA test as VG is telling.

    With respect to PSA density: I have no idea about the length, width and height but the volume is given and I am not sure what is the correct PSA that must be used. Is PSA value calculated authomatically by TRUSP?

    I see from following link that the value of PSA is important in order to calculate correct value for PSAD.

    https://www.omnicalculator.com/health/psa-density#how-to-calculate-psa-density-and-its-meaning

     

    Best wishes Frank

  • Clevelandguy
    Clevelandguy Member Posts: 1,206 Member
    #12
    Biopsy needed

    Hi Frank,

    Only a biopsy will confirm if you have Pca and also the agressiveness with a Gleason score. Did you have a TRUSP?  The PSA is usually calculated by a blood test and could be influenced by your biopsy, recently having sex, or other physical things that can irritate the Prostate.

    Dave 3+4

  • Frank-1964
    Frank-1964 Member Posts: 18 Member
    edited August 2020 #13
    Clevelandguy said:

    Biopsy needed

    Hi Frank,

    Only a biopsy will confirm if you have Pca and also the agressiveness with a Gleason score. Did you have a TRUSP?  The PSA is usually calculated by a blood test and could be influenced by your biopsy, recently having sex, or other physical things that can irritate the Prostate.

    Dave 3+4

    Thanks Cleve...

    Thanks Dave

    Yes I had a TRUSP on 17. august and waiting for histology results, expected on 3. sept.

    Yes, as VG is telling a more correct PSA value will be after 2-3 weeks of biopsy process, so I need to wait at least 2 more weeks to take a new PSA.

    Best wishes

    Frank

  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    #14
    Low PSA density means good.

    Frank,

    Let's wait for the report but I think we could be hopeful for a negative result if we take into consideration the PSA density of 0.09 (5.1/52=0.09), which is below the threshold PSAd of 0.15 considered by many urologists as the cutoff value to predict positive from negative.

    Thanks for confirming the meaning of "PSAD=0.09".

    Let's cross our fingers.

    VG

  • Frank-1964
    Frank-1964 Member Posts: 18 Member
    #15
    VascodaGama said:

    Low PSA density means good.

    Frank,

    Let's wait for the report but I think we could be hopeful for a negative result if we take into consideration the PSA density of 0.09 (5.1/52=0.09), which is below the threshold PSAd of 0.15 considered by many urologists as the cutoff value to predict positive from negative.

    Thanks for confirming the meaning of "PSAD=0.09".

    Let's cross our fingers.

    VG

    I need to mention that I have

    I need to mention that I have constant pain in my both legs, knees and feet 24/7. I have also some pain in my arms, hands, shoulders, joints, ribs, back and neck which comes and goes. Has  anyone experinced such pain?

  • Clevelandguy
    Clevelandguy Member Posts: 1,206 Member
    edited August 2020 #16
    Pain?

    Hi Frank,

    To me a lay person the pain you are describing does not sound like early Pca.  Pca usually does not spread through the whole body that quickly((August+).  Dont know what causing your pain but if it was me I would go see an Internal medicine doctor for some blood tests. The pain your describing could be from many different conditions or diseases other than Pca or it just could be stress.  Just my 2c worth...

    Dave 3+4

  • MK1965
    MK1965 Member Posts: 233 Member
    edited August 2020 #17
    Osteoarthritis

    Frank,

    pain you describe sounds like osteoarthritis.

    You are 1 year older then me, and I am alredy diagnosed with osteoarthritis in both knees and my right shoulder.

    Also, had prostate cancer and RP in November 2016.

    MK

  • Frank-1964
    Frank-1964 Member Posts: 18 Member
    #18
    Clevelandguy said:

    Pain?

    Hi Frank,

    To me a lay person the pain you are describing does not sound like early Pca.  Pca usually does not spread through the whole body that quickly((August+).  Dont know what causing your pain but if it was me I would go see an Internal medicine doctor for some blood tests. The pain your describing could be from many different conditions or diseases other than Pca or it just could be stress.  Just my 2c worth...

    Dave 3+4

    Dave  agree if it was from

    Dave  agree if it was from august 2020 but my symtoms started early in january of 2019. And constant pain started from last thursday 12. August 2020. I spoke with doctor on monday 17. August and he took many blood tests but he says blood tests are ok. The pain is worst at nights and is accompanied with heavy night sweet. 

  • Frank-1964
    Frank-1964 Member Posts: 18 Member
    edited August 2020 #19
    MK1965 said:

    Osteoarthritis

    Frank,

    pain you describe sounds like osteoarthritis.

    You are 1 year older then me, and I am alredy diagnosed with osteoarthritis in both knees and my right shoulder.

    Also, had prostate cancer and RP in November 2016.

    MK

    MK many thanks for your

    MK many thanks for your massage. However, there is no stiffness involved. So it is hard to believe that these pain are due to osteoarthritis.

    Is there any blood test that can reveal osteoarthritis?

  • MK1965
    MK1965 Member Posts: 233 Member
    #20
    Frank-1964 said:

    MK many thanks for your

    MK many thanks for your massage. However, there is no stiffness involved. So it is hard to believe that these pain are due to osteoarthritis.

    Is there any blood test that can reveal osteoarthritis?

    Frank,

    Frank,

    No specific labs that can diagnose osteoarthritis. For rheumatoid arthritis there are special labs.

    i was diagnosed by xrays ( right shoulder) and by MRI's for both knees. Pain is more General with or without stiffness.

    Usualy, once you start moving every morning, it gets better. I still run 2 miles in the mornings and walk 2 miles in the evening.

    Osteoarthitis is progressive disease and I am trying to adjust to minimize the discomfort. 
    NSAID over the counter works for me. In June I was prescribed MELOXICAM which is also NSAID but you get it on prescription.

    I can tell from my experience, it works way better compared to Ibuprofen.

    MK

  • Clevelandguy
    Clevelandguy Member Posts: 1,206 Member
    #21
    Blood test for RA

    Hi Frank,

    To answer your question on a blood test for RA check out this link from the Mayo clinic:

     

    https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653


     


    Dave 3+4

     

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