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Newly Diagnosed Clear Bone Scan

Jim1961
Posts: 6
Joined: Sep 2019

I recently received a clear bone scan and was wondering what tests I shou;d have done next.  I'm also scheduled for a MRI which I had 30 months ago.

PSA 4.5

Biopsy Reults:

Left Lateral Middle:  Adenocarcinoma Gleason 8 (3+5) in 70% of sample

Left Lateral Base:  Adenocarcinoma Gleason 8 (4+4) in 10% of sample

Right Lateral Apex:  Adenocarcinoma Gleason 6 (3+3) in 5% of sample.

Cancer in 3 of 12 cores.  

Scheduled for consulation at MSK on 9/27, Penn Medicine on 9/20.  Both surgeons I have made appointments with.  Been following AS for about 3 years with PSA only hitting 4 last 6 months and decided to do biopsy.  Is there anything I'm missing at this point?

Thanks to all of you who have been so supportive and provided great resources and recommendations.

Clevelandguy
Posts: 456
Joined: Jun 2015

Hi Jim,

Any idea of where the cancer is located inside your Prostate, the MRI could tell you that.  The 4&5 gleason scores are aggressive so I would want to know if the cancer is deep inside the Prostate or near the edge of the gland(getting ready to break out).  Have you decided on surgery or radiation?  If it was me I would consult the Oncologist and Urologist and based on all the tests see what they recommend.

Dave 3+4

Jim1961
Posts: 6
Joined: Sep 2019

Dave - thanks for your response.  The MP MRI from 2+ years ago scored a PI-RADS 2 and there were no signs of pelvic lymph node enlargement or ascites, neurovascular bundles are intact without evidence of mass, bladder is intrinsically normal, and the seminal vesicles are symmetric without evidence of mass, abnormal enhancement or hemorrhage.  I'm scheduled for the same test again and will be seeing Dr. David Lee at Penn Medicine and Dr. Alving Goh at MSK.  Considering my age and mental state I am 90% sure of doing surgery depending on the latest results and consultations.  

ufknkidding
Posts: 36
Joined: Aug 2019

Hi. I recently had RARP. I agree with Clevelandguy you should consider another MRI.  Your prior MRI is a great baseline and hopefully the new one will be similar indicating no extraprostatic extension of the cancer.  I also cannot over emphasize how important it is to maintain a focus on quality of life issues.  The more information you can get (PSA, Biopsy, MRI, etc.) with the possibility of 2nd medical opinions if desired, the better chance you have of selecting a treatment plan that fits your quality of life and cancer profile.  I'm still in the post-surgery phase so am dealing with some continence and erectile issues but am making slow, very slow, progress.  Best wishes and no matter if/when you chose to treat, be sure to go to the best treatment facility and seek out the best and most experienced providers.

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