Moving From Prostate to Bones

[Cache012]

I have been diagnosed with prostate Cancer on 8/8/08. My PSA is 7.5 and my gleason score is 6. A Biopsy and cat scan have been performed and the cancer is NOT in the lymphnodes but I have serious pain in my pelvic area from time to time. My doctor has ordered a bone scan that has not been performed yet and has scheduled me for removal of the prostate. Is it possible for the cancer to have reached my bones (Pelvic Area) if it has not gotten to the nodes?

[Ash Tewari, MD, M.Ch.]

Definitive assessment of lymph nodes should be made by a pathologist. Radiological imaging can provide clues as to the extent of disease.

However, your biopsy report shows primarily a 3+3 Gleason grade. Given your age, PSA, Gleason score, and lack of symptoms (bone pain), it is unlikely that cancer has metastasized to the bones. Further radiological testing, bone scan, will provide more information.

- AKT

[Cache012]

My Diagnosis was based on PSA tests that started 12 months ago at 4.9 then 5.9 and back to 4.9. I had not tested any further at that time for about 12 months. I was then tested and it was found to be 7.5. At that time I was sent to a Urologist who ordered a byopsy because he did not find any lumps. The report from the Biopsy reads as follows:
Right Apex-Adenocarcinoma involving one core 3+3
Right Mid-Focus of high grade prostatic intraepithelial neoplasia
Right Base-acini and stroma
Right Lateral Apex-acini and stroma
Right Lateral Mid-Adenocarcinoma involving one core 3+3
Right Lateral Base-acini and stroma
Left Apex-acini and stroma
Left Mid-Adenocarcinoma involving one core 3+3
Left Base-Adenocarcinoma involving one core 3+3
Left Lateral Apex-Adenocarcinoma involving one core 3+3
Left Lateral Mid-Focus of high grade prostatic intraepithelial neoplasia cannot rule out microinvasion
Left Lateral Base-Adenocarcinoma involving two core 3+3 Background of high grade     prostatic intraepithelial neoplasia

My age is 45 and I do not have any symptoms. This all came about from an elevated PSA test and these are the only tests done to date.

[Ash Tewari, MD, M.Ch.]

Please clarify your age and how you came to your prostate cancer diagnosis (onset of symptoms, diagnostic testing, number of PSA tests, DRE findings, etc). This will assist in answering this question in a comprehensive way.

- AKT