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Posted 12/13/2009 5:25 PM (GMT 0)
Again, I've been very honest about expressing many of my fears/emotions, even at the risk of a tad bit of "ridicule" (that's not quite the right word). I know: ("calm down," "take a step back," etc.).

Anyway, here is my concern. I will probably have to undergo a bone scan and maybe a CT Scan. With these scans, I suspect all kinds of things will light up (I've had back problems and other issues -- I'm sure all kinds of arthritis). Hence, more uncertainty and further tests (will they be invasive tests?).

I'm just not looking forward to that!

For those of you who have had bone scans, did it reveal uncertainties that required further investigations or did it reveal stuff that they knew was not a problem (ie: this is definitely a bone spur or chip or arthritis). I got to believe that at our age there would be plenty of degenerative stuff showing up.

Anyway, that's my concern at the moment. At least things are moving along a bit. I will be leaving for UMICH in a bit over 3 hours.

Mel

Posted 12/13/2009 5:34 PM (GMT 0)
Hey Mel, is there ever a time you don't worry? lol, you are going to put yourself into an early grave. I have had 3 bone scans in my life, none were invasive, and all they ever showed up was a touch of arthritis in places I wouldn't have needed a test to tell me, i.e. knees and hips. No surprise there.

I will be glad for you when you have these meetings and tests behind you, then you will have a good spectrum of data and opinions to start finalizing your primary treatment upon. I am sure you will do well with all of it.

Good luck.

David in SC
Posted 12/13/2009 5:36 PM (GMT 0)
Careful now... Don't have an accident in the snow.

The bone scan will show any injury that is actively healing. My scan showed a hot spot on my shoulder. The Uro reviewed it with me and we identified it as the spot where my rifle touches the shoulder. I had been shooting before the test. Who knew? They did a retest a week later and the spot was gone. The squirrels got their revenge I guess.
Jeff
Posted 12/13/2009 5:45 PM (GMT 0)

David:

In answer to your question, no there was never a time I didn't worry after my PCA-3 test.

Before that time, and especially before my August physical that revealed a jump in my PSA, I RARELY worried. I always believed hard work and preparation alleviated worry. In fact, I strongly believe that luck is when preparation meets opportunity.

Unfortunately, of late, I have made up for a lifetime of non-worries, I guess!

Mel

Posted 12/13/2009 5:47 PM (GMT 0)
Mel, The only thing invasive about either one is a shot or a couple drinks of contrast.please don't worry your self about the little things!

Zach
Posted 12/13/2009 5:48 PM (GMT 0)
Jeff, that will teach you to be a squirrel killer, lol.
Posted 12/13/2009 6:01 PM (GMT 0)
My husband had a number of hot spots. On discussion all determined to be the result of his "biker" days, as well as degenerative areas from previous spinal surgery. No there were no invasive tests for him, however no further assessment was requested either of any areas at the time. He did however discover that he did have an old break (upper arm) which was intact (not displaced), and which he had felt at the time, but not had treated (Didn't think it was broken). The most significant hot spots however, were those arising from previous surgery (lower back and ankle). It was all clear, but the worst part was receiving the results verbally from the Doc (we waited and collected them mid afternoon). He said (slowly.....)... "Well as you would be aware that prostate cancer often spreads to the bones which is often indicated by these sorts of spots (points...).... (pause....) however in your case and with your history, it appears it hasn't".

There was a quick clarification from us of what this (poorly expressed statement) actually meant "Hasn't what? Hasn't spread? Hasn't showed up? Hasn't worked? What are these then? etc etc"... After realising after discussion, that the hot spots were all from previous injuries, we literally RAN out of the place. So yes, it is a concern, and I am not sure how you would determine/assess suspicious spots Compiler yourself, but people reading the scans should be able to answer your questions if you can examine your scan with them at the same time. Question everything, depending on your past and knowledge of what may show in terms of previous injury and arthritis etc. We were satisfied with the interpretation and later checked it (report) with another specialist but I am not sure what you would ask/do if you were not satisfied with the explanation - sorry and hope you get some further answers on that.
Posted 12/13/2009 6:10 PM (GMT 0)
Zach:

By invasive I was referring to follow-up tests when the invariable hot spots show up in the scans.

But it sounds like most of the time they can read the hot spots and draw a favorable conclusion without having to look further. At least based on the 1-2 answers posted here so far!

Mel

Posted 12/13/2009 6:29 PM (GMT 0)
I think it helps if you tell them in advance about the potential hot spots you know about. It keeps the doctor from getting all worked up and saves you some heartburn too. I have a whole list of aches, scars, and issues that I tell them about up front.
Posted 12/13/2009 9:06 PM (GMT 0)
The bone scan will show up hot spots which as others have pointed out could be tumour or healed breaks or injuries or even that favourite of advancing years, arthritis. The inflammation which occurs when arthritis develops causes the body to lay down new material as a response to the inflammation (sometimes you can feel this new material as lumps 'n' bumps when it is on the fingers etc). I believe that the isotope in the bone scan is very quickly taken up by cells recently laid down as repair or by tumour growth. Further tests, if you can call them that, which are used to look at the "hot spots" following the bone scan are standard x-ray and CT scan. These can for the most part differentiate between tumour and healing injury.
Bill
Posted 12/13/2009 10:31 PM (GMT 0)
Mel,
The CT and bone scan most likely will show nothing. Don't worry about it. It is a simple painless test. With your biopsy numbers it is doubtful that anything bad will show up.
Posted 12/13/2009 11:51 PM (GMT 0)
In order for anything to show up on a bone scan your psa would have to be in the 100's. PC 1st spreads to the lymphnodes at which only a tumor that causes the node to be more than 10mm will show up on a CT scan. This equates to billions of PC cells. Then it moves from the lymphatic system to the bones, by that time there are usually multiple lymphnodes tumors that are growing that are each generating a lot of psa, by the time it gets to the bones and is growing, psa is usually in the high hundreds or thousands.

Save your time and money, because as long as your psa is less than 20  you will only get false positives. This is purely defensive medicine at the best and ignorance of PC at its worst.

JohnT

Posted 12/13/2009 11:57 PM (GMT 0)

yES, IT IS clear that neither Walsh nor Strum are advocates of these scans although they indicate they have their place under certain circumstances (high PSA or Gleason). But I suspect Umich will still want to do the tests (defensive medicine). If my G-score was 3+3 it would be a different story.

Roads were okay. We got here quickly and had a nice leisurly dinner. Fun starts tomorrow early.

Mel

Posted 12/14/2009 1:06 AM (GMT 0)
My urologist got me a CT scan. (with a radiologist and machine that were part of the groups practice.) It was neg. When I went up to Moffitt they almost sneered and said they would't have given me one.

Steve
Posted 12/14/2009 1:22 AM (GMT 0)
Good luck Mel you probably will not have time to ask all those questions you posed. They will be dealing with assessing your medical data, DRE or two before they get to any questions. You've got a very, very inquisitive mind so I think you will weigh it all well before making any quick decisions. Remind me to hire you if I ever have to do another major treatment, you would have more up front questions than me....(and I thought I had fair number of them-LOL).
Posted 12/14/2009 1:43 AM (GMT 0)
Mel, my husband's Gleason at biopsy was 3+4 and PSA was 6.4. Urologist said bone scan is useless if the PSA is under 20 but he did order a CT scan. The bone scan was done when John's PSA jumped up a bit in August. Both the urologist and rad onc didn't feel the bone scan would show anything but decided together that it wouldn't hurt to do it. It showed a hot spot on his right collarbone. A CT scan of the area was ordered - it was clean. Turned out the hot spot was caused by swinging a tennis racket. The radiation oncologist told us that they frequently see these types of hot spots when there is heavy, repetitious movement (tennis, golf, someone swinging an ax, etc.). The test themselves are nothing to worry about.
Posted 12/14/2009 2:57 AM (GMT 0)
I had to have a follow-up x-ray of my foot after the CT scan. My left leg looked like a war zone because I was recovering from a major infection in my femur.

Otherwise, the Ct and Bone Scan are pretty routine.
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