types of test should be performed before choosing treatment

Klains, nonograms are an online predictive tool...not a medical test.  You can plug in your husband's numbers (PSA, Gleason score) and it will give you statistical information about your husband's disease.  There are a few nonograms you can use...Memorial Sloan Kettering's website has one.  I do caution you though that these nonograms are based on statistical averages and do not take into account individual situations.

A bone scan with a PSA of 4.4 is useless.  Bone scans are used when the PSA is at 20 or higher, and even then they're not definitive.  Our urologist did not do a bone scan when my husband was first diagnosed but he did order a CT scan, which showed nothing.

Color doppler is getting more and more attention but I'm not sure if it is a stand-alone test or is done during the biopsy.  Others will chime in on this one.

If you and your husband are meeting with an oncologist tomorrow, I imagine that he or she will walk you through any further testing before treatment.  Sounds like you are both leaning towards surgery.  If that is the case, your husband will have the standard pre-op tests which might include a chest xray, blood work, general physical (to check blood pressure, etc.).  This is done so that the surgeon knows about any pre-existing conditions that he/she may have to take into account (again, such as high blood pressure or breathing problems).

Hope to hear from you tomorrow after you've met with the oncologist.  Just out of curiosity, is there a reason why you're seeing an oncologist at this stage?

 

Ct and bone scans will not give any valuable information with your low psa. Some test to consider:

PAP: this blood test is a strong predictor of PC being systemic rather than local.

PCA3: This urine test can indicate the agressiveness of the cancer.

MRIS: Scan that can determine the location of the tumor and identify if it has escaped the capsul making surgery a poor option.

Color Doppler Ultrasound: Can identify the size and location of the tumor and if it is near any structures such as nerves or seminal vessicles that would make a successful surgery problamatic. May also indicate the agressiveness of the tumor based on blood flow.

Many unsuccessful surgeries arise because of the failure to identify the tumor location and any extra capsular extensions prior to surgery. If these conditions are identified prior, then radiation would be a much better option to persue as one will most likely have to have salvage radiation because of a reoccurrance.

JohnT

Thanks for all the info, Stephie. the reason we are going to see the onocologist was to get another opionion, also the onocologist is associated with another hospital. We are stearing more toward the surgery, because it will leave options later if it returns. We are actually debating robotic or open surgery. I also needs to see a endocrinologist because he may have acromegaly. ( a hormone overgrowth) Just found that news out this week. No other test have been done that is why I was asking what the normal test were. We have only met with the urologist and the radiologist so far. Each one was leaning toward the surgery. Because of his age. 56.