Early spread
I'm due to have a bone and CT scan to determine if my cancer haa spread. No evidence showing up on MRI, is that a good sign? Tumor has broken through capsule.
Thanks Frank
Hi Frank (
). It is good that nothing showed up on the MRI. Are you sure that your doctors are doing a CT scan as a follow-up to an MRI? I ask because, as explained in this article from Memorial Sloan Kettering Cancer Center, "Where MRI really excels is showing certain diseases that a CT scan cannot detect. Some cancers, such as prostate cancer, uterine cancer, and certain liver cancers, are pretty much invisible or very hard to detect on a CT scan. Metastases to the bone and brain also show up better on an MRI:" https://www.mskcc.org/news/ct-vs-mri-what-s-difference-and-how-do-doctors-choose-which-imaging-method-use. The gold standard at finding metastatic prostate cancer is something called a PSMA PET scan. This article from our editorial team goes into further detail: https://prostatecancer.net/treatment/psma-targeted-pet-imaging. Your doctor should be able to provide additional information. Please feel free to keep us posted on how things are going. Best, Richard (ProstateCancer.net Team) thanks Richard for answering my post! I should clarify, the MRI was of the prostate area only and that's when they detected the tumor. It did not show any spread to the bones and lymph nodes in that area. I still have to wait two more weeks for the scans and my brain is frantically trying to figure out the chances of spread in the meantime. I suppose it's a good sign anyway that the adjacent area is clear and if it has spread hopefully it hasn't gotten too far away.
thank you for your input!
Frank
Hello Frank. I'm a little confused also. A CT and a bone scan can be clear and not really reveal smaller or even medium sized metastases. If your doctor feels you don't have disease outside the capsule treatment and following the PSA might be fine. But if you really want to find any metastases outside the prostate capsule I would think a PSMA pet scan or even Axumin scan would be much more likely to spot a metastasis. Richard Faust may want to comment on this and let me know if he agrees. Regardless, it sounds like things are pretty positive for your good health and we all wish you a great success with your followup and treatment! Hi
and . I do agree with Jim. The CT can detect PCa spread, generally around the prostate and the surrounding organs, but the Axumin (see: https://prostatecancer.net/clinical/axumin-early-detection) and PSMA are more precise, particularly for looking for more distant PCA. I'm wondering if your doctor is starting with a CT as it is easier and less expensive. Also, is it possible that your doctor is referring to a PET/CT scan, which combines the technology of the two (the PSMA scan is actually a PSMA PET/CT)? This article gives a pretty good overview of what the different type of scans do: https://www.cancercenter.com/cancer-types/prostate-cancer/diagnosis-and-detection. Best, Richard (ProstateCancer.net Team)
Based on personal experience MD's typically begin with a basic approach and scale up vs starting off at the top of the testing protocols. While it is understandable to be extremely apprehensive about all of this I found engaging in other activities is better all around. My worry never made it better.That said daily walks along the local bike trail was very calming for me and my wife and daughter. Hang in there ....Dennis (ProstateCancer.com TEAM)
