Bone Metastasis: Diagnosis and Scans |
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- Опубликовано: 9 июл 2024
- PCRI's Alex asks medical oncologist, Mark Scholz, MD, about metastatic prostate cancer, especially low-volume metastatic disease and de novo metastatic disease (meaning, newly diagnosed without prior treatment for prostate cancer). They discuss how PSMA PET scans are changing how we think about different disease states and whether it is possible in 2023 for a patient with early metastatic disease to achieve a cure or extended remission.
0:07 How does prostate cancer typically metastasize?
2:19 Prostate cancers are typically categorized by Gleason score, which represents a prostate cancer's level of aggression. At which Gleason score is metastasis possible? Do higher scores mean metastasis is more likely?
3:36 What constitutes "lymph node metastasis" in prostate cancer and how is metastasis different in prostate cancer compared to other cancers?
5:29 What kind of situation counts as "early stage metastatic disease" compared to advanced metastatic disease?
6:26 What is the meaning of "cure" and "remission" in prostate cancer?
6:56 De Novo Metastasis: Is there a possibility of achieving a cure after metastasis has occurred?
8:11 People tend to have a negative perception of chemotherapy; however, in prostate cancer, the most commonly used chemotherapies, Taxotere and Jevtana, and relatively well-tolerated. Can you explain how chemotherapy in prostate cancer compares and contrasts with more intense forms of chemotherapy in other cancers?
10:31 What does "oligometastatic disease" mean?
11:38 Bone pain is a common symptom of metastatic prostate cancer in the bones. Can you explain how that symptom would develop or how it might be distinguished from other bone pains?
13:37 Is PSMA PET scan the best body scan to look for metastases? Should a person still get a bone scan in 2023 if PSMA PET scans are available?
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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website at pcri.org or contact our free helpline with any questions that you have at pcri.org/helpline. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's RUclips channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
#ProstateCancer #MarkScholzMD #PCRI
God bless you for your informative explanation and your calming and patient attitude
This is another excellent informative and calming presentation.
1. My prostate cancer returned with bone metastasis dx via Psma pet scan at spine T10 and L1, right second rod and femoral lymph.
2. I am currently being tx with Lupron q3 m injections and daily Xatandi P.O. medication.
3. This is my first time ever leaving a comment on you tube.
4. THANK YOU VERY MUCH -!
your information and how you present the data is both educational, calming and empowering.
Thank you again for providing hope-!
How are your treatments going? I have bone matastasis from prostate to my pelvis and 6th rib, waiting on biopsy at hospital.
I have been watching these videos for over 2 year's, since I was diagnosed with prostrate cancer.
They are not only very informative, and educational, but cutting edge technology. At it's best. And every time I watch one of thses video's, I watch them several times. And each time, I pick up one more tidbit of information. Putting the best "team" together for yourself , as Dr Elizabeth Heath talked about a few weeks ago, is probably the best thing you can do for yourself and the disease. Remember, ignorance is not stupidity, it is only lack of knowledge!
It is amazing to me, how many of us has had some sort of prostrate cancer. And how it was treated or delt with. Putting together a great team, paired with education, is definitely a win win, situation.
Great work! Go Team!!
Do you have symptoms before?
Alex and Mark.. Thank you for being such a great partner and advocate for me and others on this journey. Your questions are always so well thought out, presented and discussed. With great appreciation ❤
Thank you very much for this video. I (GS 4+5 = 9) had one bone met and lymph node mets. I started on ADT + Nubeqa after diagnosis, had six rounds of Docetaxel last summer / Fall then radiation to the prostate / pelvic lymph nodes and bone met in Dec 2022 / January 2023.
After watching this presentation, it makes me very glad we pushed for aggressive therapy early.
Thank you for what you do!
As someone with MPC, a Gleason of 8, and starting on hormones (ORGOVYX), I'm finding your videos extremely sobering. Currently part of a new 5-year trial. Thank you for your wonderful work.
this is the best video about the bone metastasis
WOW! THIS DA" BEST PROSTATE CANCER VIDEOS ON RUclips, THANK YOU ALEX !
A thousand "Thank Yous" for the support I have received from your channel since a diagnosis of Gleason 8 w/ bone mets last year. You've helped me to keep my diagnosis in perspective. 👍🏽
We hope everything goes well. If you ever have any questions, feel free to contact our helpline, here: pcri.org/helpline.
Whats your symptoms bro
Love these videos
Dr Sholz
I was diagnosed with met prostate cancer to my bones and unfortunately my liver also .
On round 5 of chemo and Nubeqa
PSA was at 204 upon diagnosis its now at 2.3 .
I'm cautiously optimistic the chemo treatments and hormone pills seem to be helping for now .
I dont know what the future will bring but for now treatments are giving me some quality of life and hope .
Ill ask my Oncologists on how many mets are on bones and liver .
The information on this video and others are pretty much the care im receiving you describe .
Thanks to both of you for all the information and thoughtful way its presented.
Im a little upset my family Dr missed my prostate cancer , i clearly asked over the years for PSA bloodwork , but was treated for an enlarged prostate.
Get checked demand a PSA and a digital old school exam , seems like the new Drs have a new protocol .
Bottom line mine was missed and i fear the endgame ....
From what im told my prognosis is at best a few years .
I can only hope i stay strong
Indeed, stay strong, Carmen. I’m pretty sure I’ll be following along right behind you. None Mets already; real good chance of liver.
But you know what? We all do this journey, and eventually it ends. And then, the start of a new adventure.
I always carry with me in my mind the quote by Woody Allen: “I’m not afraid of death. I just don’t want to be there when it happens.”
It does no good to be afraid. I know this. But until things change, we just live our lives and hold our lives closely.
I wish you well.
@@andrewmacfarland5253
Thank you Andrew for the kind words , i wish you all the best .
Im hoping my treatments keep it at bay for years to come .
I feel good right now , noticing the hormones treatments making me weaker , ill start walking and light weights.
Its a lot to digest when first diagnosed im grateful for Alex and Dr Scholz page , i know my medical team has me on the same treatments Dr Scholz speaks about .
In a weird way i look forward to seeing their videos it gives hope and options .
Its not all gloom and doom
If i can help in anyway reach out .
Thanks
Carmen
You guys are the best!!! Thank you for these calm, fact-based messages. They make a difference when we so often hear gloom and doom.
Thank you for this!! My husband's doctor has been saying "chemotherapy is the last resort".....but he also says that's the next step.....which has had us both very scared! Thank you for this
It’s a serious business, of course, but don’t be scared. Whatever is coming by way of treatments is endurable, I promise. And then, after all the prerequisites have been completed, if further treatment is necessary, there is the still-new drug Pluvicto that delivers teeny doses of radiation directly to cancer cells, wherever they’re located. And it’s painless, promise.
Don’t be scared. It’s just another journey in life.
Thank you for this particular video. I am in the UK procedures with doctors are somewhat different. I an 77 and last year was diagnosed with metastatic prostate cancer, I am currently on Xtandi and lh/rh injections so it's good to hear Dr Scholz talk about what happens with the disease
My father 72 years old and diagnosed prostate bone mets before 20 days plzzzz tell me hoe r u now and your treatment what is life expectancy???
(hi there, since most of the readers are from the USA, i am glad i found you. I am in the UK, and it's quite different here, I should say. I am also on Xtandi and Zoladex inj - every 3 months. I am 73, quite active and keep following the advice of moving and exercising as much as I can. Following the prostate op 2022 march, I am extremely relieved that i can urinate pretty much normally. But troubles me is my oncologist saying that i have to be on ADT all my life. Needles to say the side effects sometimes are overwhelming - both physically and mentally. Still I keep in relative good control, how about you?
@@boykogify I have not had any operation, there was talk of TURP but I suffer with COPD so there were major concerns that I wouldn't tolerate the general anaesthetic well. The COPD limits the amount of activity I can do, but I do what I can. I am now on self catheterisation twice a day, not pleasant but you get used to it.
@@boykogify Have you thought about bilateral orchiectomy (testicle removal) as an alternative to ADT?
It's awesome that your team is so informative and keep us educated about what we are living with every day. Thanks so much for just keeping it simple. Stay safe and much ❤️
Thank you for these compassionate and informative presentations which have helped me get my mind around systemic treatments and understanding the technical language and the process in choosing the best approach with the medical staff .
After an 11 year hiatus from treating the disease so long ago I thought I was home and hosed but sadly not so ... here we go again.
What a brilliant man....thank you
Thanks for another informative video I always like seeing them even though I’ve been through most everything you talked about it’s always encouraging to see what’s going on.
Thank you very much for your information, y’all doing a great job, God bless both of you
Thanks again
Thanks for sharing your knowledge
Excellent presentation ❤
I am confused. Two years ago I was diagnosed with prostate cancer. So I asked the Oncologist if it was a family member what would he recommend they do. Three months later I had my prostate removed laparoscopically , plus a lymph node from each side. The tests came back clear on the lymph nodes. Three months later my PSA test was still up slightly at 6. So I had a bone scan and a CT scan and it showed shaded area on the right inside hip bone (they didn't call it metastatic) and an 11 mm tumor on a lymph node. That part didn't make sense. So I had to start getting hormone injections every 6 months and take Enzalutamide 4 capsules a day. So I made changes to my diet, supplement's and bought a Sparkle Mat (which has FIR, PEMF therapy, Red light therapy and gem stones), plus already owned a FIR dome. Then I had another bone scan and CT scan last November and the bone scan came up clear (then it said it was metastatic) and the CT scan showed the tumor shrunk to 6 mm. On one of my follow-up appointments I asked if the tumor disappeared could I get off the hormone injections and stop taking the Enzalutamide and I was told no, I would have to take them for the rest of my life because even though undetectable I still have prostate cancer cells floating around. I was also told that if I did stop taking Enzalutamide that it would not be effective anymore. 😵💫
Have you ever thought of asking your doctor, can you take an holiday period off hormones therapy? While monitoring your PSA. That’s my game plan, my PSA has been 1.5 and steady for a few months now. In March 2022 I started off at a PSA of 46! (Before radiation treatments and hormones therapy for prostate cancer). As soon as my 18 months of hormones therapy is over (November 2023) I want to take 3 to 6 months off and see what my PSA numbers are looking like. If steady I will continue; but, if my PSA gets to 5 then I stay or go back to my Luprons shots again, and that’s what’s up!
He said no I’m on hormone therapy and Enzalutamide for the rest of my life. My PSA when I had surgery was 8 and now my PSA has been less than 1 for a year and a half. My testosterone has only been between 3 and 4. That’s why I don’t understand the discrepancies
@@MaxnMacey I would get a second opinion.
16:45 I was given two years to live - Gleason score of 10 and metastatic spread to lymph nodes - told I’d be on Lupron injections for the rest of my life. Two years after that prognosis I started interval treatments of Lupron. I haven’t needed an injection for over a year now. Give it time. Stay away from meats and dairy. I had a PSMA scan last September which showed no signs of prostate cancer anywhere in my body - not even in my prostate. No radiation. No chemo. Just diet and Lupron.
You can do this!
@@dennismaneri that’s encouraging! I’m currently facing a recurring Prostate Cancer and it has metastasized to bones. I’m 60+ days into my plant based diet. Feeling good !
I also am on an ADT pill form.
I have bien following close this videos and they are precisé an really helpfull i Can tell because I am a Radiologist my self and Dr a intervier lady are very objetivé and to the point thanks and good bless you both
Excellent content..
Great information
This was excellent. I am just past a year after a RP for Gleason 9 tumor in the prostate, and am still basically cancer free. I have passed two PSA tests where the PSA was undetectable (less than .02). I watch several videos each week as I am moving along the journey, and you folks at the PCRI are amazing. Your seminar 3 weeks ago was amazing. I have watched it twice!
im just at 4 months with a gleason 9 and undetectable , hows it going for you If I can ask?
@@nelsonoliva2119 I remain cancer free. I do an ultra-sensitive PSA every 6 months and thus far all have been clear.
@@tboyleninetynine so good to hear sir Im very haopy for you. Did you have any extra prostatic extension or a positive margin anything like that? my gleason score was 9 but psa was 9.52 when diagnosed and I moved very quickly to remove it, I also only had 1 core with gleason 9 but still its a tough mental battle at times. I had some epe and a very small positive margin, but had the top surgeon in sylvester cancer center, so im remaining positive. My mri and psma scans were clear thank God, and no lymphnode or seminal vesicle invasion either . Its comforting to hear another gleason 9 person say they are clear a year later. I hope its forever. Cheers
@@nelsonoliva2119 I did have an epe, but there was no lymph node involvement (I had all the abdominal nodes removed) and the surrounding tissues were also clear. I dodged the bullet to be sure. My PSA was 9.7, and I asked the surgeon to take out as much as he felt necessary to give me the best chance. I had 11 of the 20 cores with gleason 9 stuff.
I keep hearing using hormone therapy can be curative, even in this presentation regarding bone metastisis. However, at the next turn, Dr. Sholz says that hormone therapy only surpress testosterone which stops feeding prostate cancer. My question is then if it only surpresses prostate cancer, how can it be classed as a cure? To me, it appears to only be palliative in that it puts prostate cancer "to sleep".
That figure of 35,000 annual deaths would undoubtedly include some who, like my older brother, were never treated. He never went to the doctor for anything but at the age of 69 he fell down one day and couldn’t get up, was taken to the hospital where he was diagnosed with end stage prostate cancer and died a few weeks later.
Sorry for your lost’ your brother situation sounds like me’ but deferent that I was going to the VA’ because psa gradual going up’ after my first biopsy when it was around 4’ the VA lost my biopsy’ at 16 psa I started to get a second biopsy when it hit 30 psa’ just did a PET-CT and waiting for results’ now last year a stepped over boxes 📦 and fall hard face down’ I went to VA emergency’ due left knee pain’ turned out ok’ weeks later hip pain right side that got worse and locking up’ and constant knees in pain’ both 24/7 especially all night and limited walking’
Can you comment on Keytruda and its use in highly mutated prostate can
Can you comment on Keytruda and its effectiveness on highly mutated prostate cancer?
My husband was diagnose with prostrate cancer about 18 months ago. It was stage 4 , 5+5. scans were done, showing bone mets all over in his bones and pelvic area nodes. Chemo was done without much improvement. PSA continues high at 103. Abirterone with prednisone. His cancer is very agressive. would it have been better to do the abiraterone first. Going thru the chemo was tough on him. with alot of side effects. He is tolerating the abiraterone much better, bone pain is pretty much constent.
ask your doctor for NOBEQA IT DROPS MY PSA FROM 200 TO 1. 8 IN A MONTH
En español donde lo puedo encontrar soy de Argentina Dolores pcia bs as❤️😍🇦🇷
PCRI.... He wants to know if you video's in
spanish
My bone scan and MRI in 2017 showed no lumpth node invasion but two spots on the pelvis. My Gleason Score was 4+3. I have been on Lupron injectable, initially every 3 months and for the last two years every 6 months. I just had a PSMA PET Scan which showed no lymph node invasion and now nothing on the pelvis. During this whole period my PSA has never fallen below 3.0. I would love to give the Lupron a rest but because of my 4+3 Gleason my urologist my urologist has recommended against it. Is radiation still an option along with Lupron or by itself?
Is your Lupron injection a 6 month dose or are you taking a 3 month dose every 6 months? Thanks in advance.
My father had a laminectomy to remove a tumor from his spine 3 weeks ago and still can't move his legs. He refuses to do radiation or chemo and has been taking valasta.
What's his symptoms before diagnosis
@@BimboTV stage 4 prostate cancer that spread to his bones in 2019
@@bobbydigital737 no urinary symptoms?
@Prof. URADA yes he was unable to empty his bladder. He passed away on the 16th. The cancer spread to his lymph nodes causing his lower parts to swell
Very very good informative videos have made a huge difference to me and the way I deal with my prostate cancer. Thank you .
Do you have symptoms before diagnosis
Maxnmacey... Were you on stage 9 / 10? Terminal stage?
🥰🥰🥰🥰🥰🥰🥰🥰🥰
Can prostate cancer be injected and killed with the inactive polio virus? Has anyone ventured into a possible gain of this approach?
Another video where you would think nobody dies from prostate cancer. Too bad 35,000 men die each year in the US of prostate cancer. A neighbor, a business associate and friend all died of prostate cancer but you wouldn't believe it could happen listening to this expert.