A new concern
Hi everyone - my name is Tom and I received Brachytherapy for my prostate cancer back in 2017. My recent PSA numbers have been between 0.8 and 0.5. A recent trip to the hospital for heart problems garnered me a CT Scan that showed "possible metastatic bone disease T5 thru T8". My oncologist didn't feel that the metastasis is from the prostate cancer since my current PSA #s are so low. He did however, suggest that to ease my mind, I should ask my general practitioner to have an MRI done just to rule out things. Well the results are in and the MRI confirms what the CT showed. My logical Dr. Spock self though begs to ask, "Is it possible that the prostate cancer metastisized before the brachytherapy and did the metastasis just not show up until now?" I am curious if anyone in the group has come across a similar situation. Thank you for reading my long intro and question and I am hoping that perhaps someone else may have a similar experience. PS: I am now waiting for a referal appointment back with the Oncologist that was submitted by my general practitioner.
While not a medical professional, I meet with anywhere from 30 to 40 men a month who are at some stage in their prostate cancer diagnosis . The one consistent theme that occurs with everyone -- this disease impacts each one of us in different ways.
My understanding is you only need 1 prostate cancer cell to migrate into another part of the body to cause some trouble. Given there are millions of cells involved when it comes to prostate cancer, I suspect anything is possible.
The good news 😀 is you have discovered what is going on. And it sounds like you are in the care of an oncologist who should have a handle on getting things under control.
... Dennis(ProstateCancer.net Team)
Hi Tom. Sorry to hear about the metastasis of your cancer. As to whether the cancer escaped the prostate before the brachytherapy or is a recurrence following treatment, it may be impossible to ever know. There seem to be instances and a case to be made for either. This article discusses patterns of recurrence in patients who underwent brachytherapy: https://www.redjournal.org/article/S0360-3016(19)32623-9/fulltext. What is clear is that local, pelvic nodal, and distant recurrences all can occur (as is the case with other treatments as well).
It is great that you are already setting up to see the oncologist, as figuring out next steps now seems key. Wishing you the best and please feel free to keep us posted on how you are doing. Richard (ProstateCancer.net Team)
Tom, unfortunately too many of us have had the experience of a positive PSA after treatment, known as a recurrence. For example, 30% of us who had a prostatectomy have a recurrence, which obviously started before we had the prostatectomy. The positive for those of us having had a prostatectomy is that if there’s any PSA after the surgery, it means the cancer is still in us, which means radiation. My big question for your doctors is why did your PSA stay so low, although it appears he’s stumped on that question? (In my case, I had a Gleason 9 PCa, and it grows FAST.) One thought I’d suggest looking into. There’s a scanning test widely used in most of Europe called the Prostate Specific Membrane Antigen (PSMA) that is only produced by PCa cells. And it shows on the scan exactly where the PCa is in your body so they know exactly where to radiate. Since it’s not approved by the FDA yet, you can only have it done in the US at Memorial Sloan Kettering in New York City; UCLA in California; and I think another cancer center in Texas. (Before it became available in the US, if I had a positive PSA again, I was going to go to Amsterdam to have the scan as I think it’s that good.) As for the PCa in your bones, ask about Xofigo. I have a friend who’s just about to start on Xofigo since his PCa is now in 6 rib bones. It’s a radioactive material (Radium 223) that the PCa in bones ingests and the radium kills them. It’s not a picnic taking it, but having watched my dad die in 1987 from bladder cancer that was throughout his bones just like PCa does, I’ll do anything to try to kill it. All the best. Len Smith ProstateCancer.net Moderator
