Recently diagnosed, awaiting conclusive bone biopsy

User

Posted 08 Jun 2016 at 20:49

I was diagnosed in February with locally advanced PC (it has gone to the seminal vessels but not lymph nodes). That was two days after my dad had died of it and I had no symptoms apart from some tiredness, certainly no bone pain. PSA 6.5 and Gleeson 9. A subsequent radio isotope scan showed a dark patch on one rib, which though the radiologist felt was mets the consultant said it was rare to see an isolated high uptake like that and asked if I had had broken ribs at some point - yes, since I had ridden a motorbike and had several accidents when younger, but couldn't remember which ribs were broken. A further MRI seemed to indicate there was possibly some kind of bone injury but a further ct scan said they could not see this and diagnosed probably mets. So without any firm conclusion, we have asked for a bone biopsy and are awaiting a decision on this before either radiotherapy or chemo. They told us at one point they had taken a view that it was not mets so we just don't know where we are and it is like a roller coaster from hell. We are pushing for a diffinitive diagnosis and thinking of taking a second opinion from another consultant out of area. Has anyone else had this kind of issue?

User

Posted 08 Jun 2016 at 22:19

Hi Windy, I have no experience of the situation that you are in but I wish you well with whatever outcome there is and whatever treatment plan you have.

Regards Chris/Woody

Life seems different upside down, take another viewpoint

User

Posted 08 Jun 2016 at 23:43

Hi Windy,

Sometimes it is not possible to get a definitive opinion from scans. I had the best scans available in the UK at the time last year but had divided opinions on assessment between leading hospitals. In my case this was whether an iliac node was cancerous. In your shoes I would also ask if a biopsy of the suspect met could be done.

Barry

User

Posted 09 Jun 2016 at 00:01

Rare to see people getting bone biopsies on here - more often, the onco prescribes hormones and then re-scans a few months later ... if the suspect area has shrunk it is a met and if it is still the same size, it is assumed to be an old injury. If they are offering a bone biopsy and you are up for it then great - fingers crossed for you

Edited by member 09 Jun 2016 at 00:02 | Reason: Not specified

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

User

Posted 09 Jun 2016 at 06:42

Windy,

I had both a MRI and Nucleur med bone scan before my biopsy. When I went for the biopsy I asked if these had shown any spread and was advised that there was evidence of spread to my hip. When asked where , he pointed to a point on my left hip. This is an area where I have had much pain over the past 30 years, and actually I was quite relieved that something was showing there. I suffer from sciatic pain and it's possible that I also sustained an injury in this area which has made it worse. I was told that the scans cannot always differentiate between cancer and old injuries.
It was decided that I would have a further MRI scan to concentrate on this area to confirm whether it was cancerous or not. All these points were discussed in detail with at my first Onco meeting. No further action has been taken.

I can understand your concerns though and I too was really worried by what was showing from the scans. But in my instance it merely confirmed that my hip had been injured at one time and has affected my sciatic nerve. The only confirmed cancerous spread was to the lymph nodes and seminal vesicle.

Best of luck for your treatment .

John

User

Posted 09 Jun 2016 at 10:45

Hi Windy

The problem with a biopsy is that even with cancer present it can often return a result of just normal bone cells. In your position, if the PSA is still high I would ask for a PET/CT or PSMA scan if available, as the cancer if present will take up the choline or antigen and light up on the scan.

All the best

Roy

User

Posted 21 Jun 2016 at 17:20

Thanks all. Further update. They have now offered a bone biopsy in mid July or a radio isotope scan in August which is 6 months after the initial one. The radiologists feel it is a met but I have heard before of such a patch being an old injury rather than anything more sinister, which we hope. My PSA is now down to 0.13 from 6.5. So i guess what we need to know is would the cancer in the bone have diminished so dramatically as a result of the treatment that it may not show up in a bone biopsy and would therefore the radio isotope scan be a better indicator. Any thoughts anyone?

User

Posted 22 Jun 2016 at 15:56

Windy,

Can't believe you have a bone met with such a low PSA reading. Almost certainly your suspect area is an old injury. With such a low reading, you'll come to no harm by waiting for the second scan. I would avoid the biopsy and needless discomfort. I remember years ago I had a "suspicious" area in my neck. After six months it was unchanged and evidently down to wear and tear. That was nine years ago! Bit more wear and tear since then, I guess.

I would just add that scan resolution is variable across the country. If you want the best go for PSMA (I think there's only one centre and nowhere near me) or Choline PET, where I've had to go to QE at Brum for an associated matter.

Good Luck with whatever you decide.

AC in Northants

User

Posted 22 Jun 2016 at 16:16

Windy, we have a member Si whose PSA was around 3 but had multiple bone mets and went straight for early chemo. PCa does seem to particularly like ribs and your doctors are clearly concerned about this suspect area so perhaps best to follow their advice?

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

User

Posted 22 Jun 2016 at 16:48

I had psa 43 and the bone scan scan showed a hotspot on one of my ribs. They put it down to previous injury , but admitted it was a strange rib to break ( No 1). Then I ended up T4 Gleason 9 and lymph spread x5. I'll be interested in future scan results to see if they got it wrong.
Despite Dr's getting it wrong quite a lot ( they're only human ) , it is best to take their advice mostly as they genuinely want to help. Sometimes they lack the resources and time to do their job as well as they would like...........

Notification

Join the online community now.