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15.5 years post RRP -- concerning new or just part of it?

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WCavinSC
WCavinSC

RRP with Dr Partin (Johns Hopkins) in August 2005. Post-surgery gleason 3+4, T2c tumor, Margins clear. Unremarkable side effects, save for gradually worsening leaking which was helped with a mesh sling in 2006 and then an AUS device in 2017 (which gave me a decidedly fresh outlook on life!). No issues with erections/sex since 3-4 months post-surgery. PSAs have been undetectable since, and urologist decided in 2018 to only require the PSA test every 2 years moving forward. IMPORTANT NOTE -- PSA was never a good predictor for me anyway. My initial PSA test when PCa was diagnosed in June 2005 was extremely low.... 0.07 (yes.... point zero 7). A hard spot on my prostate during DRE identified possible issue, which was then confirmed by biopsy with multiple positives in both lobes. Age at time of original diagnosis -- 37 (yes, 37).

ER visit this past Thursday for extreme pain in abdomen and some shortness of breath. Chest XRays showed nothing of concern. Urine tested positive for blood in urine but everything else no issues. CT scan ordered to look for root cause of pain, which was diagnosed as Acute, Uncomplicated Diverticulitis and antibiotics prescribed and starting to work. Here's where the concern comes in....

The CT scan also showed 2 sclerotic lesions -- 1 on my 7th rib, 1 on my Left Iliac bone in the pelvis. This is where I am concerned. I know that chance of recurrence will always exist, but was hopeful that after almost 16 years, and surgery going so well in 2005, I was out of the woods and "clear". I may still be, and all of this worry from the last 48 hours will be for naught and only due to the infection my body is fighting. I'm also a strong believer in the sovereignty of a mighty and good God, who uses all things good (even when they appear "bad" on the cover). Scripture tells me to not be anxious, and I'm praying and working on that piece.

Any advice for the specific issue I'm facing -- any of you faced it? Appreciate all of you!

0 likes, 2 replies

2 Replies

  • barney34567
    barney34567 WCavinSC

    Posted

    I understand your concerns.

    Spot on a CT or "lesions" are not necessarily worrisome.

    If the PSA has not changed much since surgery, then it is unlikely that you have metastatic disease.

    I recall during my workup the PSA kept galloping, so I was treated with surgery, RT and ADT.

    In my case a PET/CT showed a spot which two experts could not decide upon. One of which "disappeared" some time later.

    If you were a family member I would counsel:

    1. Was it a CT or PET/CT you had? The later is preferable; and
    2. Ensure the PET/CT was reported on by an expert in prostate cancer. If he/she was not, see if you can take those images to someone who is an expert to report on. There is no need to repeat the scan.
  • barney34567
    barney34567 WCavinSC

    Posted

    Sorry I forgot to add that if the spot is found to be benign, it does not hurt to repeat the scan say in 6 months or a year IF say your PSA rises.

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