Aching legs and hips but low psa

User

Posted 15 Apr 2015 at 17:32

Hi,

Just a quick question please - my Dad is currently on Zoladex and he has had his last psa test today. The reading being 0.012 which is fantastic considering he had his prostate removed and it increased to 15 without it.

Is it correct to assume that if the PSA is low then there is no metatastic involvement, only he has been having pain in his hip, calf and ankle and the GP asked him to ask the oncologist for a bone scan but he said it won't be cancer spread due to the psa being low and is therefore not going to do one.

He was Gleason 8, contained with no node involvement but had it all removed in 2011. Since then his psa rose, he has been on casodex but that stopped working and is now on Zoladex. He gets very breathless and looks pale not sure if this is the Cancer or treatment.

Thanks

User

Posted 16 Apr 2015 at 21:08

Bit surprised no one has replied to your question , but sometimes posts get lost down the list.

I am sure someone will have the answer, as someone a few days from a 12 month post op PSA test I sometimes wonder about various aches and pains and your question is one on my list at my nurse led clinic next week.

Thanks Chris

User

Posted 16 Apr 2015 at 22:07

This is a tough one to answer - on the one hand, it is crazy of the onco to suggest that it couldn't have spread due to the low PSA - has he forgotten that the PSA rose to 15 even though the prostate had been removed??? Where does he suggest the PSA was coming from. I feel really cross for you. On the other hand, prostate cancer tends not to go to calves and ankles so I wonder if this is more likely to be muscular or plain simple arthritis - if he has hip problems, that is likely to casue transferred pain further down the leg or sometimes in the opposite leg!

If he was my dad, I would be contacting the onco to firmly request that scan, even just to put your minds at rest.

Being in pain will make him pale, and breathlessness is a common side effect of HT

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 12 May 2015 at 18:33

Hi,

Thanks for the replies I had. Dad went to see a physio who gave him some exercises to do and he is due back there tomorrow. In the meantime he had a copy letter from the consultant to the Doctor requesting the Dr sort out an MRI scan and appointment to see a spine specialist! He is due to see the Doctor on Friday - which is all wasting time in my opinion.

It has now been going on about 10 weeks and I can tell its getting worse as he isn't off getting the bus everyday. Some days its in his calf and ankle and others all down his leg - like a dull toothache :-((

I called Prostate support who were of the same opinion as the Consultant that if the PSA is that low it is not likely to be in the bones. What I didn't ask him though was if it goes to the lymph system or organs does this also affect the PSA? just thinking back to when he saw a radiotherapist and he said look out for lumps and bumps - that wouldn't suggest the bones anyway.

Any help would be greatly appreciated. We are all starting to have our suspicions now that something isn't good and I just want to get it looked into as I think the consultant has been a little careless in dismissing it so readily and not wanting to see him for 12 months.

Tracey

User

Posted 12 May 2015 at 19:08

Tracey

I would not be happy in your position. Just because your Dad's PSA is low does not mean the disease could not have spread. There are men on here with bone mets who started out with a PSA in single digits. PSA is not the be all and end all of every situation it is just a normally reliable guideline.

Lyn was correct when she said mets are not usually found in the long bones initially like arms and legs the most common places are pelvic area. hips, ribs and spine. However I would never presume anything.

If your Dad had a successful prostatectomy which kept things at bay for a while only to have his PSA start to rise then something is creating that. If HT was given and that has brought it back down again that is all well and good but the MRI and then after that if necessary a bone scan should really be arranged to check exactly where that PSA is being created from. The MRI will show up any potential area for concern either in the organs, lymph nodes or bones to some degree.

The one thing I would say is that some of the HT drugs do cause breathlessness and weakness for some Men much worse than others. several men here cannot take Bicultamide (casodex) for that reason. Another cause of muscular aches and pains can be higher than normal calcium levels. This can happen if the bones are not processing in the way that they should, there are two main functions in bone maintenance cells die and disperse causing a calcium output and new cells are created, these normally go at a matched rate so we notice nothing but it one gets out of synch with the other it can cause problems that are not PCa related.

That is a very basic explanation but hopefully it gives you an insight.

When you see the DR on Friday make sure you tell him your concerns and let him know that you feel very anxious that more is not being done to invesigate the underlying problems. If it turns out to be non cancer related the relief in itself may help improve the situation.

I will be thinking of you on Friday

best wishes

User

Posted 15 May 2015 at 12:09

Hi, just updating.

Dad went to the Doctor who agreed with the consultant that due to the PSA being lower than before Dad doesn't need to worry about any spread?!!

He has still ordered an MRi on his spine at the consultants request, think I would have preferred it on the abdominal area personally, but we will run with that.

The Dr is of the opinion that it is a vascular condition based on what Dad is explaining rather than a back complaint. Looking at that on the internet its basically a circulation, blood flow, heart, stroke issue! He does have peripheral neuropathy in his feet anyway so it could possibly tie in I suppose that if the nerves aren't working correctly in his feet then the circulation may also be a problem.

Dad is over the moon and I can understand why. He has put him on Co-Codamol for the pain at the moment and we will await the scan. I think the Vascular route will be looked at after the results on the scan.

Feel free to let me have any info on Vascular issues if anyone has them.

Regards
Tracey.

User

Posted 15 Aug 2017 at 18:47

This is a great post...Thank you so much!!

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