Prostate cancer

A PCa diagnosis can only be 100% following a biopsy, where the cancer is seen under a microscope.

But a CT, especially combined with a very high PSA can confirm an advanced prostate cancer with  - at a guess - 99.9% accuracy, especially once it has spread to the bone.

As for symptoms, the tragedy of prostate cancer is that many people get no symptoms at all until the cancer is very advanced; often bone pain.

In most cases, they do seek a biopsy, in order to get that 100%.

"Could be", "suggests", "most likely", "impression" and "possible" will invariably be used on a CT report, even if the consultant is certain, because they're looking at an image, not the actual cancer. The report, and the slides, will have been reviewed at a multidisciplinary meeting by the whole team, especially as there was no biopsy.

Though everyone is unique, there is a pattern of spread that suggests a particular form of cancer; simply reading that sentence from the CT report, it 'sounds like' prostate cancer, and unlike many other cancers. As the report says, the lymphadenopathy alone could be lymphoma; but the bone metastases would (almost certainly) rule that out.

Is there anything specific that makes you doubt the diagnosis? He's clearly unwell with something?

As to "How long does dad have?", That's an impossible question to answer - even for the team managing his problems. While we have 'a picture' of how he is now, that doesn't tell us how fast the cancer is growing, and there's no way to know how effective the hormone therapy will be; it varies with the individual, and that also depends on how advanced (at a cell level), the cancer is. But if all goes well, possibly years - I'd be more concerned about his kidney function and general health. It is possible that he has had some symptoms, but has considered them 'part of growing old' - the story of PCa men everywhere, alas.

Hi

I agree with Heinous, it all points to PC, the hormone tablets is the first wave of bringing down his PSA, he may move on to a different course once this is lowered. 
surprised they did not do a biopsy, but there may be a reason for this. If he has a future appointment and someone goes with him, arm yourself with a bunch of questions and write down the answers. It helps deciding on where to go what decisions to take.

There are many of us on here ( including me ) who have had this disease for a number of years, treatment has greatly improved, so let’s hope he gets the right medication.

stay safe.

Joe

Hi

my husband was diagnosed with APCa in 2018 at the age of 58. He had no symptoms and had gone to the doctors with a possible ear infection. He had some random bloods taken as part of an MOT (he rarely needed to go to the doctor before this) and one came back suggesting a bone or liver problem. His doctor did more bloods to check liver and his PSA. His PSA result came back at 1110 and he was referred immediately to the urologist at our local hospital. At his hospital appointment he had DRE and we were advised there and then that he had APCa. No biopsy carried out as they said there was no doubt. He started HT injections on the same day. He had to wait a couple of weeks for a CT and MRI scan, these were to check how far it had spread, not to confirm diagnosis. Once his scan results came back the hospital team discussed his treatment options and he started chemotherapy. 

many men can live a long and active life following a diagnosis, unfortunately this wasn’t the case for my husband who passed away last November but I do know men who are either in remission or living an active life with it, so try to stay positive. 

The MacMillan website provides very useful information on treatments, symptoms etc, and what to expect.

if there is a Maggie’s Centre near you I would recommend you check out their support meetings or even just pop in for a chat, lockdown rules permitting. You could go together or individually depending how you both feel. They do have a men’s cancer group and a prostate cancer group. They can also help with advising what help is available and help in filling in any forms to claim financial help. MacMillan can also provide this help.

Stay safe and positive

xx

Hi Rosedale6

It was very sad about your husband, yes you are right, there are many of us ( me included ) who live for many extra years, my incurable PC means, it will get the better of me at some time, but as long as I can I will help others just like your doing.

It is hard for the family, I hope your getting by. I tell my wife I will fight all the way, I hope you keep giving advice and help, talking is a good thing, you ever want to just send me a message if it’s private I chat to everyone.

Stay safe

Joe

Thank you Heinous for your message. The CT scan and terms used make more sense after your explanation. They are looking at an image and not the actual cancer so they only commented on the enlarged prostate and more emphasis was placed on the bone lesions and lymph nodes which tells us the cancer has spread. Dad started Bicalutamide which increased his urine output and produced a stronger flow. The consultant said that they will try with the medication and see if that helps to clear the kidneys. I hope it's working. Dad says he is not in any pain and carries on with his normal routine. He has a blood test tomorrow and will know the results the following day. Thank you

Hi Joe - thank you for your message. The doctor said that his PSA confirms the cancer so no other diagnostic tests are required. Yes, thank you - I have written down the comments my parents made during our conversations and will bring them up when we see the consultant. I hope the medication works, dad has a blood test tomorrow and will know the results the day after. Fingers crossed his kidney function has improved. Thank you.

Hello Rosedale6 - thank you for your message. I'm sorry to hear about your husband. Thank you for sharing what happened. I'll have a look if there is a Maggie's centre near me, thank you. It's been an anxious time and the mind thinks of the worst case scenario. Dad has a blood test tomorrow and an outpatient appointment on Wednesday so we should know a bit more than about his treatment plan. Thank you