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Can Prostate Cancer Spread Even Though PSA is Negligable during ADT

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Posted 6/17/2016 5:26 AM (GMT 0)
Hello Members,

Have any of you heard of prostate cancer spreading even though the PSA score was low during ADT?

The reason for the question is that I have very aggressive cancer that has already spread outside the prostate. Even though my most recent bone scan and CT were clean and post Lupron shot PSA at .02, which is outstanding, I have had a minor pain in my right hip and on the outside of my left shin bone for over a year now and never had pain in these two areas before.

If any of you have any thoughts as to whether it is possible for PC to grow despite low PSA scores during ADT, I would love to hear them.

None of us are doctors, but whenever somebody responds to a question like this, it means a lot. We are all in this together even though there are not a lot of concrete answers.

Thanks. I just updated my signature of anyone needs to see my history.
Posted 6/17/2016 6:07 AM (GMT 0)
There are some rare types of PC that never put out a lot of PSA and are unresponsive to hormone therapy from the start. But they are very rare, thankfully. You had a very high initial PSA, and it was reduced by hormone therapy, so it's not likely to be one of those. Although it is possible, albeit unlikely, that you have a mixed type.

Usually metastases have to grow to a certain size before they become painful. If the bone scan and CT didn't show anything before you started HT, it was probably not very big, but that doesn't mean there was (and is) nothing there. The shin is seldom one of the first places for a met to occur, although the hip may be.

So it is possible, but not likely, given your excellent response to HT. There's not much you can do about it at this point anyway. Maybe discuss Zometa+Celebrex with a medical oncologist, but I don't know if that would have any benefit before mets are detected.

- Allen
Posted 6/17/2016 7:49 AM (GMT 0)
Bob,
The pain in your hip and shin could be many things but I'm betting it's not mets with your low PSA. That doesn't mean you shouldn't continue to monitor it and take care of the pain though.
I think that ADT in addition to the other treatments I've had have accelerated many aches and pains for me. My joints have become more rigid and inflamed, and certain pains from my original mets (especially in my left pubic/hip area) have never really gone away.
Mention the pains to your oncologist and/or urologist and if you don't get answers you can try going to other docs to treat what could be unrelated to your cancer.
Let us know what you find out. And good luck.
Posted 6/17/2016 2:01 PM (GMT 0)
I was on ADT for 2 years following my surgery. My PSA went undetectable for those two years. Then we stopped Lupron. Six months later my PSA was 0.07 then 2.0 in three months. A bone scan found mets on my spine (L2), pelvic bone and ribs. I asked the question at MDA, "Did this happen while I was on Lupron". Answer "We don't know". My guess is the cancer had already spread and the initial pre-surgery bone scan & CT scan did not see anything because it was minute. Then the HT-resistant cells were selected out and started to show up.
Posted 6/17/2016 3:06 PM (GMT 0)
You say you have had pain in your hipbone and shin for over a year now and started lupron 3/16... I suppose it could be cancer.. what does your MO think
Posted 6/17/2016 3:28 PM (GMT 0)
Thanks everyone for taking the time to reply. You have all given me a lot of information and I wish all of you the best. The hip and shin discomfort is so minimal and PSA has dropped so low, I'm going to just try to forget it and enjoy life.

Bob
Posted 6/17/2016 10:32 PM (GMT 0)
I would try for one of todays sophisticated scans and see if it can detect any cancer in the locations that are giving you problems..If not, then chances are it's something else that's causing you the pain....
Posted 6/18/2016 12:27 PM (GMT 0)
Bob my PSA was less than one when I developed bone mets in my spine. It took less than three months from discovery to severe pain in back and shoulder. All the while PSA was less than 1.0. The bone mets got me booted from the prostvac trial at NIH. (I did not get the vaccine only Xtandi) I had the mets radiated because of the pain and the location. Instant relief after five doses.

Now on chemo. about halfway through.

Don
Posted 6/18/2016 8:40 PM (GMT 0)
Don826
Tell me about the chemo. What are you getting, what are SEs , how long will you be on it?
Thanks
Bob
Posted 6/19/2016 11:00 AM (GMT 0)
Break, There is a raft of information on chemo on this site as several of us have completed it, are going through it or expecting to start. You may want to set up a separate thread. The experiences run the gamut from Sonny's relative lack of SE's to others who just get knocked over. I am somewhere in between.

Here is a short list for me.
Mouth sores (got ahead of this on the second round. Peroxyl mouthwash frequent rinsing and L lysine supplement once a day)
Fatigue (Just take naps and don't try to do to much)
Fever and chills (WBC dropped hard and I wound up with an infection that required antibiotics)
Mental fog (not a lot just enough to notice that I am off my game a bit)
Skin rash (skin doc said it was chemo induce keratosis. Not serious and clears up between treatments)
Lack of taste to food (everyone's favorite. Cannot taste salt just sweet stuff. Meet taste like I do not know what. Veggies are good)
Nine pound weight loss in four days (not eating and mouth sores)

I will be getting six doses given three weeks apart. Not sure what the dose amount is.

Don
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