Pls clarify, is bone scan and MRI necessary with G7 and PSA < 10?

In order not to confuse the recent thread with high PSA (200), Steve
said something about scan not worth doing since it will not detect any
metastatic with low G score. Here is my question:
I recent;y have a second opinion of my biopsy slide, and he concurred
with the pathologist first report (G7). Before deciding on a treatment
course, he wants me to do a bone scan and MRI. Is this the normal
progression of events? If not, please explain why not. Thanks.

cmdrdata wrote:

> I recent;y have a second opinion of my biopsy slide, and he concurred
> with the pathologist first report (G7). Before deciding on a treatment
> course, he wants me to do a bone scan and MRI. Is this the normal
> progression of events? If not, please explain why not. Thanks.
>
There's no way I'd want to choose a cancer tx without knowing where my
cancer is located, and scans are a big step in that direction. The bone
scan is standard because traveling PC cells seek bone; I thought the
pelvic CT was more common than the MRI, but not sure about that. It
would be a shame to mess up one's life needlessly with RP or RT if the
cancer is already somewhere else, and some would refuse ADT if the
cancer is thought to be localized.

I.P.

"cmdrdata" <cmdrdata@mail.com> wrote in message
news:1163181279.515284.175890@b28g2000cwb.googlegr oups.com...

> I recent;y have a second opinion of my biopsy slide, and he concurred
> with the pathologist first report (G7). Before deciding on a treatment
> course, he wants me to do a bone scan and MRI. Is this the normal
> progression of events? If not, please explain why not. Thanks.

I would say it is normal.

When I first entered this foray, the standard path was PSA, biopsy, CAT
Scan, Bone Scan, then surgery. Things changed some after that; to the point
that many docs did not bother with the CAT and Bone Scan if the patient was,
say, a G6, Stage T1a and 2.2 PSA.

However, if a G7 doesn't push you over the theoretical threshold, then your
4+3=7 probably does (I don't recall your Stage, as I've been confusing you
with YELNATS -- also 60 with a 7.4 PSA)

In short, yes it probably is normal for your DX.



--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
PSA <0.04
Non Illegitimi Carborundum

"cmdrdata" <cmdrdata@mail.com> wrote in message
news:1163181279.515284.175890@b28g2000cwb.googlegr oups.com...
> In order not to confuse the recent thread with high PSA (200), Steve
> said something about scan not worth doing since it will not detect any
> metastatic with low G score. Here is my question:
> I recent;y have a second opinion of my biopsy slide, and he concurred
> with the pathologist first report (G7). Before deciding on a treatment
> course, he wants me to do a bone scan and MRI. Is this the normal
> progression of events? If not, please explain why not. Thanks.

Why not ask the specialist?

Mary
>

The only negative aspect of the bone scan and MRI is the cost to you
and or your/our insurance. That's really the only reason to not do
these things. Lots of doctors used to (and many still do) recommend
these for no good medical reason, cost be damned, for the Gleason 6,
PSA <4, T1c bunch but that has fallen by the wayside more or less. In
your case, it's probably wise to go through with them. If they do pick
up something it will be bad news although it will save you from
surgery. Most likely the scan and MRI will show nothing. Beware
though that the bone scan will show lots of "hot spots" that will scare
the bejeezers out of you but they almost always are the result of old
bone injuries long forgotten. Best of luck with all this.
Dave Perry
cmdrdata wrote:
> In order not to confuse the recent thread with high PSA (200), Steve
> said something about scan not worth doing since it will not detect any
> metastatic with low G score. Here is my question:
> I recent;y have a second opinion of my biopsy slide, and he concurred
> with the pathologist first report (G7). Before deciding on a treatment
> course, he wants me to do a bone scan and MRI. Is this the normal
> progression of events? If not, please explain why not. Thanks.

cmdrdata wrote:

> In order not to confuse the recent thread with high PSA (200), Steve
> said something about scan not worth doing since it will not detect any
> metastatic with low G score. Here is my question:
> I recent;y have a second opinion of my biopsy slide, and he concurred
> with the pathologist first report (G7). Before deciding on a treatment
> course, he wants me to do a bone scan and MRI. Is this the normal
> progression of events? If not, please explain why not. Thanks.

What is your age and health otherwise? Is the doctor taking
advantage of your insurance to pay for the tests?

I can't have an MRI because of metal implanted - total hip
replacement.

I was diagnosed with ankylosing spondylitis in 1976. That is one of
the 100+ forms of arthritis recognized by the Arthritis Foundation.

It has spread from the lower back to the neck - now fused from the
disease - to the hips, legs and knees.

I was diagnosed with PCa in June '01, second opinion Jan '02.

Cancer centers cannot appraise my CAT/bone scans because of
the damage already caused by the A.S.

I was in your boat..... Initial scan & CT is necessary to mark before the
likelyhood of future mets. Remember all previous injuries and areas brought
on by arthritis will light up. In 5 years I have had 15 scans.....



"cmdrdata" <cmdrdata@mail.com> wrote in message
news:1163181279.515284.175890@b28g2000cwb.googlegr oups.com...
> In order not to confuse the recent thread with high PSA (200), Steve
> said something about scan not worth doing since it will not detect any
> metastatic with low G score. Here is my question:
> I recent;y have a second opinion of my biopsy slide, and he concurred
> with the pathologist first report (G7). Before deciding on a treatment
> course, he wants me to do a bone scan and MRI. Is this the normal
> progression of events? If not, please explain why not. Thanks.
>

Thanks to all who responded. I am 60 and excellent health otherwise, BP
is around 120/78, and average weight, exercised regularly. Minor GERD.

As a matter of fact, it just seemed hard to believe that there is this
monster inside that is destroying me without any external symptoms.

MAS wrote:
> I was in your boat..... Initial scan & CT is necessary to mark before the
> likelyhood of future mets. Remember all previous injuries and areas brought
> on by arthritis will light up. In 5 years I have had 15 scans.....
>
>
>
> "cmdrdata" <cmdrdata@mail.com> wrote in message
> news:1163181279.515284.175890@b28g2000cwb.googlegr oups.com...
> > In order not to confuse the recent thread with high PSA (200), Steve
> > said something about scan not worth doing since it will not detect any
> > metastatic with low G score. Here is my question:
> > I recent;y have a second opinion of my biopsy slide, and he concurred
> > with the pathologist first report (G7). Before deciding on a treatment
> > course, he wants me to do a bone scan and MRI. Is this the normal
> > progression of events? If not, please explain why not. Thanks.
> >

If the reason for your question was that you perhaps thought that the
ordering of those tests might implicate some unspoken concern of your
uro, no - it is normal - meaning routine SOP. On the other hand it is
probably normal because it is defensive medicine at best and
fee-inflating at worst. However, your question as stated is too
general; a PSA up in the 10 range is beginning to be of concern for
mets. What was your PSA? FWIW, I had a PSA of 33 and nothing showed on
bone scan, MRI, or ProstaScint.

Bill Denton
RP 2/12/02
PSA 1.10
Memphis