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This question was answered on Sat 26, Apr 2008 03:42am by Dr Paul S, MD

prostate cancer - Should I go through any test before my prostate removed?


    
Asked by user (Male; 44; high blood pressure; Relevant drugs:avalide ) on Fri 25, Apr 2008 08:49pm

i was diagnosed with prostate cancer on 02/28/2008. i am 44 years old. psa level was 6.18 and 5.77. my urologist did a 12 core biopsy which 4 came back positve all on the right side. 5, 10, 15, and 90 percent. my clinical stage is t1c. before going for my physical i only notice some lower back pain not knowing anything about prostate cancer. since being diagnosed i have notice more back, knee, hip and feet pain. my akaline phosphatase level is 130.00. i have seen three urologist all thinks bone scan was not needed based on my psa and gleason score. finally my urologist doing the surgery sent me for a ct scan with contrast of my abdomin and pelvis which showed a small cyst on my liver, but everthing else being normal. i was still having problems with my back, knee, hip, and feet. my internal medicine doctor sent me for a bone scan. bones: normal pyhysiologic distribution of activity. joints: uptake in the knees, hips, and feet is typical for degenerative change. uptake in the proximal right tibia is also likely stress related. soft tissue: physiologic distribution throughout the soft tissue and excretory system. impression: no evidence for metastatic pattern according to the radiologist. i am due to have the da vinci robot surgery on 05/01/2008 next thursday. my internal medicine doctor will be on vacation until 04/30/2008. wanted to know if i should have any other test before having my prostate removed. thanks in advanced.
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Answer by Dr Paul S, MD  on Sat 26, Apr 2008 03:42am:

Hi there. I'm relieved to learn that your pains are mostly due to degenerative changes and not from prostate cancer spread. For your surgery, it depends on the institution and the doctors in it if cardio-pulmonary evaluation and clearance is needed before the operation for patients who have no other co-morbid illness. Some centers require cardio-pulmonary clearance routinely for males who are 45 years old and above. For patients who have other condition like hypertension or diabetes, then additional work-up or tests are needed to assess the state of these conditions so that these can be controlled or optimized before any operation. I suggest you discuss some tests like ECG or Chest X ray with your doctors if they deem it necessary in preparation for this surgery. Again, it will all depend on the institutional protocols and/or if you have other co-morbid conditions. Good luck in your operation and may it be uneventful. Regards and God bless.

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Follow up:

Clarification by royross on Sat 26, Apr 2008 06:10pm: 
i was wondering about more test such as mri and pet scan because of the uptake in joints. do you think the ct
scan and bone scan is enough. i did not want to have surgery to find out it has already spread to the bones. i
just wasn't sure about the uptake in the joints and should i be satisfied with the bone scan and ct scan.

Comments:

Comment by royross on Sat 26, Apr 2008 10:52am: i was wondering about more test such as mri and pet scan because of the uptake in joints. do you think the ct scan and bone scan is enough. i did not want to have surgery to find out it alrady has spread to the bones. thanks again
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