Confusing scan results

Hi Robbo

It is a CT scan that really verifys a bone scan not an MRI so u need to wait a bit longer I,m afraid. Hopefully the CT scan will reveal all u need to know.

Regards

Steve

Hi Robbo

It is a CT scan that really verifys a bone scan not an MRI so u need to wait a bit longer I,m afraid. Hopefully the CT scan will reveal all u need to know.

Regards

Steve

Hi Robbo

Welcome to the Prostate Group .  I'm sorryb to hear about your dad's situation and I hope you'll find the answers you're looking for here.

Firstly, just to  clarify,   you say "but has started treatment"     - I think you missed NOT out?  I will assume that you did and your Dad has NOT actually started treatment yet, because until all results are in, it can't be decided what treatment options are appropriate.  This includes the scans.

You also say "all tests have been carried out",  did this include a biopsy?  If he hasn't had a biopsy then all tests have NOT yet been carried out.  I ask this because it's usual these days to have an MRI BEFORE a biopsy.

If I'm reading the rest of what you say correctly, please say if I'm wrong  then

a)  Your dad had an MRI scan which showed a shadow on his hip

b)  He then had a bone scan which showed 7 suspicious areas  on his ribs.

c) He has had a CT scan

I hope the following explanation helps -

The three types of scan are all different and show different features and aspects of what's being scanned.

An MRI scan (Magnetic Resonance Imaging) uses magnets and radio waves to generate images of the different SOFT tissues in the body., i.e. organs, muscles, skin etc.  It  is therefore useful for detecting possible tumours and other abnormalities of soft tissues.   

If your dad a does have a tumour in his prostate gland  then the MRI will detect it and give information about its size and position.

A bone scan involves having an injection of a radioactive isotope which is readily absorbed by bones.  The scanner detects gamma radiation and  will produce an image of the bones  (NOT the soft tissues).  This will show abnormalities in the bones.

The CT scan is a "Computerised Tomography" scan  which uses X rays  to build up a very detailed 3D picture of both soft and bone.  This will help identify what the abnormalties in your dads' ribs are.

All being well the "spots" in your dads' ribs will turn out to be due to trauma to the bones, which might not necessarily have been fractures. 

Hopefully, the reason for carrying out these scans has been explained to your dad.

The biopsy, is quite important as it provides further information about the size and position of any tumour in the prostate.  After examination in a laboratory the biopsy will also be given a "Gleason Score".    This is explained in the booklet I refer to below.

Macmillan have a booklet on the tests for prostate cancer which I hope you and your dad find helpful.  Click on the link  below then then click on the relevant image,  you can then click on "Download pdf" to get the booklet.

Having Tests for Prostate Cancer

You can also get more comprehensive information and support with any other needs you or your dad have in relation to his cancer from a Macmillan Information and Support Centre (MISC).  There are many dotted about the country, usually based in hospitals.

You can find the nearest MISC to where your dad lives by visiting this web page

Location of MISC

I'm afraid the worst parts of being diagnosed and treated for cancer seem to be are "waiting"  and "not knowing".   Waiting 10 days for a result is not that unusual and results are often only given at an appointment.

Hopefully your dad knows when his next appoinment is.

If there are any other questions you have or anything else I can help with, please don't hesitate to get back to me.

Hi Uroboros

Thank you.  We have all the info given to us by nurse and Dad has had everything.  Biopsy, Psa 145 Gleason 4 + 4 8,  mri, hip shadow so bone scan requested.  Hip shadow ruled out presumably but showed hot spots on ribs.  Treatment of bicalutamide and prostap started awaiting - ct verification for chemo or radio therapy.  I suppose I had a long winded way of asking after all these scans and xrays why has it not still been verified - as a t3a N0 M0 is very different to T3a N0 M1 and all the hanging around - another 3 weeks and it literally is like waiting to be hung :-(!   Results were not ready at his appointment yesterday despite it being for the purpose of getting a treatment plan.

What trauma can show on ct scans please?  I understand osteoarthritis etc in the joints but can't think what would show on ribs :-(

Thanks x

Thanks Steve - it's just like waiting to be hung :-(!  Can't really see what else the hot spots would be though other than cancer - and we have 3 more weeks to wait now!! It's torture.

Jackie

Hello again.

Bones can suffer some damage without completely breaking, for example they can be "bruised" in the same way that skin can i.e. damaged blood vessels.  Bones do have blood vessels!

Abnormalities do show up in bone scans in 2 ways, either as areas where there is "low uptake" of the isotope, due to weakened areas, and areas where there is a higher uptake, called "hot spots" because those areas appear brighter in the image.

You are correct unfortunately in  thinking there is a significant difference between M0 and M1.  The CT scan is the decider.

I think it's pretty bad that they didn't have the CT results at the appointment and get them quickly.  The waiting and not knowing is awful in any event without expecting them, then not getting them.

I wonder how your dad is taking this,  I find it's often the cancer sufferer's friends and family can be more distressed than the actual sufferer, but nonetheless it is awful for him.

I hope you get the result very soon and it's M0, but in the sad event that it's M1, there are still treatment options available and it is particularly good that your dad's spine and liver don't appear to be affected.

It doesn't suit everyone but it may help if your dad can talk to other sufferers at a support group.I can recommend again you contact your nearest MISC. they are so very helpful

Robbo

The spots can be there for other reasons as has been previously mentioned.

Any kind of trauma to the ribs for whatever reason could cause this.

I agree, terrible that u have to wait so long but hopefully things will work out ok.

Steve

Thank you.  Yes it's terrible however whilst the medical care has been excellent the administration side has been appalling even to the point that someone else who was gravely ill had his notes! Whilst I want to research and find out everything dad is quite happy to leave me to it and doesn't want to know prognosis and outcomes he just wants to know the treatment plan and to get on with it.  You're right, whilst my way if dealing is to research mum is a very different story and is a wreck at the moment.  She doesn't even want to venture far from home without me being with them in case he takes ill :-(! This is partly due to the infections and sepsis following his biopsy though :-( 

Thanks again

Thanks Steve

Does this trauma have to be new or can it be old? Not sure if I mentioned but he was a fettler in a foundry which means he held equipment against his body whilst working - mot sure if this can have affected anything.  He also has COPD and my friend specialises in pulmonary issues as she said a COPD sufferers xray can look crazy but presumably that would be lungs and  not the bones.  All we can do is wait :-(! 

Thanks again

I have to be honest and say that I don't know for sure , it would just be speculation, the CT scan will hopefully give u the answers.

Why don't u ring them up on Monday and try and push things along.

Steve