I think you need to talk to the radiologist.  Neither of your docs can
answer the question for you first hand.

Ron,

As several of us have indicated, you have a golden opportunity here,
Gleason 7 with no palpable tumor and no statistical reason even to get a
bone scan, much less worry about some inconclusive finding.  And you've
got one of the finest surgeons in the country to do your RRP.

Don't screw this up.  Tell your GP you'll get back to him in a few
months about that MRI.  Have your surgery, get cured now.

jimhoney
not a doctor

I can't recall off hand what your numbers are but if you're a typical
T1c with PSA on the low end of the scale and Gleason in the middle
range, the chance of any cancer having spread to your rib is zip.
There was a guy on the group (actually his wife did all the posting) a
couple of years ago with "hot spots" on a couple of his ribs and he was
all in a dither.  Of course it was nothing, probably the result of old
sports injuries.  When PCa spreads it almost always goes to the bones
nearer the prostate first, not the ribs.  Bone scans are becoming less
common anyway unless there are other indications such as high PSA or
the doc needs to make a payment on his new BMW at the expense of your
insurance.  Listen to your surgeon, get the surgery, you'll be fine.
Dave Perry

on 3/16/2005 5:01 AM Ron B said the following:

In addition to what I e-mailed you earlier off list and what everyone
else here has expressed as their opinion, here's one more thing to consider.

When I was scheduling my surgery with Dr. Catalona a bit over 5 years
ago (Taa Daa!  Today is the fifth anniversary of my RRP and we're still
trying to find any trace of PSA and failing miserably<g>) one of the
first things I was told by his office was that he wanted a bone scan.
This was never mentioned by my urologist who made the DX.

That tells me that Dr. C does value the bone scan as a diagnostic tool.
 It also tells me that with his years of experience in treating PCa, he
probably forgotten more about PCa than most internists will ever know.

If he says it's not PCa, I'd go with his thoughts. BUT...  it MAY be
something else so it needs to be looked into if only for your piece of
mind.  One step at a time, Ron.  Lose the PCa in the prostate, then
check out the ribs.  It makes absolutely no sense at all to delay the
RRP or worry about the rib at this point.

Even if it IS PCa that's spread to the rib, you still want to remove the
bulk of the tumor as the first step in your fight against this enemy.

Good luck on Monday and we'll raise a glass to you five years hence when
you claim a "likely victory" over PCa.

I absolutely agree with what all of the others have written.  I won't repeat
their arguments, only to say that I have taken the same route.  Something
showed up in a scan that could delay my treatment if attended to now, and I
have put it aside until later. Cancer comes first.  And don't think that
scans are oracles.  I was once told that a chest x-ray showed cancer and in
the end it turned out to be old scars from an early pneumonia.  I have also
been in an experience where my GP was so zealous and wanted me to r eceive
certain tests and invasive treatments and my specialist thought it was all
unnecessary.  The specialist knew best and I have always been so glad that I
followed his advice.

Let me join the others to put your mind at rest about this.  If you have a
good surgeon, and I gather from the posts that you do, go with confidence
for your surgery..First things first.  I am taking my own advice.

Last winter (Feb 2004),  I worked on my kitchen plumbing.  For weeks
after that, I had a pain in my right side.  I went to my doc who had
X-Rays shot, showed nothing but as long as I was there, he pulled
blood for a full-up panel.  

PSA 10+, so he sent me to a Uro, who couldn't DRE anything but did
a, ugh, biopsy.  Gleason 7.

As part of the pre-rad assessment, I had the MRI and bone scan.  The
bone scan was lit up like two Christmas lights on my right side.

"Have you, ever, broken your ribs", the Rad-doc asked intently.

I don't know.  I had this incredible pain, right here, after working
under the sink.  It was from the edge of the baseboard, just the
weight of my body.

He relaxed, "you broke your ribs from the pressure."

I told my primary doc that.

He said, "Well, we should be certain" and sent me for more X-rays.  
This time they put a tiny lead bee-bee right where I said the pain
was.

I don't think the few hundred bucks for additional X-rays is
anyone's BMW payment.  It's just a good idea, a judgement call.

The Rad-doc took my story.  My primary doc (who is a known
perfectionist) wanted to check it out.   Similar to your situation.

I don't see why the additional imaging would delay anything.

It's also a little odd that if one of the 'benefits' of surgery is
the full organ biopsy and 'knowing', that there are so many calls
not to bother with the MRI.

Just go ahead with the surgery, they say.  Why, only in one case in
a hundred or a thousand, who knows, would the MRI reveal that there
is no point to the surgery because the cancer has already spread.

Seems almost like a religeous thing.  It's more important to join
the club...  I realize that this is unfair but there definitely is
that underlying sense.  

anywho.

Can't you do both?  Have the MRI and have your chosen procedure?