2nd Combidex MRI update

As a diagnostic any scan will be affected by HT as it immediately shrinks small tumors and makes them very difficult if not impossible to detect. It may still pick up very large masses that have not yet shrunk.

It is already confirmed that your BF has lympnode involvement. And with a Gleason 9 and a psa of 51 it is almost certain that surgical sampling of the lymphnodes and surgical removal of the prostate would not have cured him. A prostascint scan is inaccurate and now would be even more so that he is on HT. With those stats it was 99% certain that the PC was not contained and surgery would have been used as a debulking procedure only. I hope your BF was informed of this before his surgery. What did his CT scan and bone scan show before his surgery

If your BF does not already have a good prostate oncologist then I would suggest getting one of the top ones as it is well past the stage that any surgeon or urolgist can provide any meaningful help. I would also suggest "Beating Prostate Cancer, Hormone Therapy and Diet" by dr Charles Snuffy Myers as he also had PC than had spread to the lymphnodes.

Scans can be used to monitor progress, but only the Combidex will pick up small mets, PET scans should only be used if they are free and part of a clinical trial, because they have shown to be almost useless in detecting prostate cancer. You should also be aware that Combidex is no longer available as the imaging agent used is no longer in production. It is hopeful that in a year or two a new imaging agent can be found.

Good luck ,and at this point in time PSA and other blood tests may be a more accurrate way to monitor progress than any scans.

JohnT

John,

10 days ago I had a high-resolution MRI scan combined with a gadolinium contrast agent. The scan was carried out in London, UK.

I'm not sure how this differed from a Combidex scan? Maybe they are both similar?

I understand the resulting images have an additional clarity that help the radiologist to identify possible tumours. As always, I believe the skill and expertise of the radiologist is absolutely critical in interpreting the results. I guess it's much the same as having a very experienced surgeon carry out treatment.

I had hemi-ablation HIFU treatment in October last year. Although my first two PSA results were very satisfactory, I had a nagging doubt in the back of my mind because I had a conflict in diagnoses between my original National Health Service biopsy which showed five Gleason 7 cores on the right side, and a subsequent multi-core template guided biopsy carried out privately, which showed the right side to be clear. My NHS MRI scan had also showed tumours on both sides of my prostate with possible left extra-capsular extension.

I think I can now feel reasonably confident that the NHS biopsy and MRI scan were incorrect. However, it is very puzzling, because I can accept the possibility of a false negative, but a false positive is rather more difficult to understand. I'm hoping there isn't a man out there somewhere who was told that he was clear when in fact he has Gleason 7 in the right side of his prostate.

The letter from my consultant following this latest MRI scan said - "Please find attached the MRI study. You will see that this is completely clear. The necrosis has completely resolved and there is no MR evidence of any residual tumour in the treated left side. The untreated right side, as we would expect, also shows no evidence of any tumour. I hope you find this reassuring."

I do realise that MRI scanning can only go so far in identifying smaller tumours, but it's an encouraging start.

Cheers,

Jeremy