I should provide more information. I'm 52 and everyone believes the
cancer should be contained. Just that some think, take the tests now
what the hell, or not necessary now considering probable containment
and not enough information until surgery can look around inside or
until the PSA's are tracked after treatment.

WhiteSoxFan

I believe that Dr. Strum considers the tests to be a waste of time and
money, *except *where the initial staging tests indicate a high-risk case.

My initial diagnosis (dx) was PSA 5.7 ng/mL, T2a (should have been T2b),
Gleason 4+5=9, five of six specimens on one lobe (a Gleason 4+4=8 tumor
had been missed by first biopsy). Mine was the sort of case in which Dr.
Strum would have approved the CT and bone scan.

It appears that WSF's case is close enough to high-risk, and the tests
would be prudent. Bear in mind, though, that the bone scan will not pick
up micrometastases.

Regards,

Steve J

"The thing is to expect nothing in particular, but be aware of the lack
of enforceable guarantees or enforceable contracts with
nature/god/entropy as to the condition or durability of our bodies."
-- Brian Brunner, PCa survivor, December 12, 2005 on The Prostate
Problems Mailing List
Thank you, Brian, for your insight.

The first book I picked up, Walsh, says a bone scan can be very helpful in
advanced cases (Gleason > 7, PSA > 10, >=T3). I believe he meant ORs, not
ANDs, in that list. He downplays CTs. Even though my case met only one of
those criteria (Gleason 4+4), my initial uro gave me bone scan and CT just
because the Gleason 8 is so aggressive. Both were negative for PC mets,
which made us both feel much better about localized treatment. However,
post-op pathology bumped my pre-op T2 consensus to a T3 (seminal vesicle
involvement), so there was one more after-the-fact vote for the bone scan.

It was just blind luck, and irrelevant to this forum and thread, that my CT
caught a whole 'nuther primary cancer, an asymptomatic, large carcinoid
colon tumor, which would probably have signed my death warrant within a year
or two. Several docs have put is simply: my PCa saved my life, at least for
the time being.

I.P.

Probably a waste of time in some cases, but in your case, you have to rule
out existing mets, especially if you choose surgery.  The pressing issue is
that Gleason 8.

I not a medical authority but why leave something to chance? I'd say
absolutely get it. I also had a endo-rectal MRI which gives your
surgeon more insight prior to surgery.

Next to the biopsy this the most uncomfortable test in my opinion. I
also had a  Cystoscopy to rule out any bladder cancer. This test my
local uro did in his office. Not fun but quick.

Good luck.

Personally, I think the CT and bone scan are a waste of your insurance
dollars, yet I continue to have them regularly.  My initial PSA was 59.2 and
nothing was detected on the original scans.  My surgery was 06/02/1999.  My
PSA has been rising very slowly the last three years, and on my latest CT
and bone scans there is still no signs of cancer.  It is still just to small
to be picked up.  I had a bone scan in August, and told the doctor I was
sure it would not detect anything, and it didn't. One rib had some "glow" to
it, but nothing definitive.  I keep doing it out of curiosity.  It is only
natural that I want to know where this cancer is located.  As I told the
doctor, it is a contradiction of thought to say I wish this thing would
hurry up and make a presence. Yet, I am relieved when the test show nothing,
as it means the cancer is small.  Yet the PSA is still rising, so we know
that it is there.

Dale P
Denver, CO

At the risk of bringing on some wrath, I'll jump on my bandwagon again.
These tests rarely show anything worthwhile with respect to prostate
cancer for men with numbers such as yours.  All they do is inflate our
insurance costs, subject you to additional testing, and give you more
grief since the bone scan almost always has "hot spots" indicating the
spread of the disease when in fact they are the result of old (even
minor) injuries.  Besides, what are the tests going to tell you?  They
won't erase the results of the biopsy.  I suppose if there were
definitive evidence of big chunks of cancer in your bones you could
avoid the surgery but if that were the case, your PSA wouldn't be 5.79.
Dave Perry

My uro thinks they cause more anxiety than they are worth.  Unless of
course they suspect metastisis.

I have CT and Bone Scans every quarter. The main reason is to keep a handle
on micro-fibers of cancer floating around and looking for a home. To date I
have had ten sets ....

My 2nd uro had me get a bone scan. When I asked him why he said it's
good to have a baseline: if PSA starts rising later they can compare
bone scans and distinguish between mets and old damage.