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This question was answered on Tue 29, Apr 2008 04:36pm by Dr Heinrik M, MD

Diagnosed with prostate cancer and was having body ache.


    
Asked by user (Male; 44; high blood pressure; Relevant drugs:avalide ) on Mon 28, Apr 2008 03:30pm

i was diagnosed with prostate cancer and was having some body aches so my doctor sent me for a bone scan on 04/16/2008 and the radiologist stated the bones had normal physiologic distribution of activity, showed uptake in joints but stated typical for degenerative change. no evidence of metastatic patttern. ct scan of abdomin and pelvis normal. what worries me is that both shinbones, ankles and hips seems to flare up with minor pain every 5 minutes or so. when having blood test over the last 3 years my akaline phosphatase has been elevated to about 130.0 wasn't sure if the pain could be do to something other than prostate cancer. my psa was 6 and gleason score was 6 in february. i also was wanting to know how a radiologist could tell the difference between degenerative change and metastatic pattern and should i have additonal test because of the uptake in joints. i was wanting to know because i'm having the robotic surgery for my prostate thursday 05/01/2008 and didn't want it removed if the cancer has spread. any insight you can provide me would be very helpful. thanks in advance.
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Answer by Dr Heinrik M, MD  on Tue 29, Apr 2008 04:36pm:

Hi, The radiologist looks at distribution of suspicious areas and the intensity of the signals. There are general patterns for metastatic prostate cancer. Bone disease usually involves the lower areas of the spine because of a network of veins that is associated with the prostate. From a clinical standpoint, this is compatible with your PSA. The intensity of the signal may not be able to differentiate metastasis from arthritis. In this case, X-rays of the involved joints are used as points of comparison. I think what you need to understand is that all these tests and estimates are based on selecting more likely scenarios rather than deciding on absolute answers. There is a perception that tests are always better due to their objective nature, but not everything that a test may show as abnormal would require treatment.

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