Could Be Something Could Be Nothing : Been There Done That : Well Then Welcome Back

The outcome of my full body bone scan is described below in an e-mail to my immediate family and a close friend:

"The radiologist's report reads in part: There is a localized area of increased uptake (of radionuclide) associated with the very posterior aspect of the 9th or 10th rib on the left. There is also a curvilinear increased uptake associated with the region of the trochanter(upper femur) on the left.

The radiologist verbally advised my primary physician, Dr. Hansen, that he detected no clear indication of metastasis. By phone Dr. Hansen explained  the suspicious areas could be the result of earlier bone trauma of one type or another, e. g., fractures or degeneration. In view of my Pca history neither the radiologist nor Dr. Hansen could rule out metastasis and recommended a full body scan six months from now. Incidentally these findings were supported by six standard x-ray views of the spine and pelvic region conducted subsequent to the full body scan."

As the long-term reader with a good memory will readily appreciate, it is not the first time this Pca warrior-veteran has been caught up between the devil and the deep blue sea. And in all likelihood, it will not  be the last.

The next order of business will be an endorectal MRI suggested by Dr. Myers at our most recent routine appointment. This should be completed within the next three or four weeks.

Good News Bad News(?) Edition

As reported in my prior entry Dr. Myers adjusted my treatment plan in response to the concerns I expressed about  reduced sexuality and increased breast tenderness/tissue deveopment  issues. He thought two 50 mg Casodex pills per week rather than three would restore my quality of life. Although too early to quantify, I am pleased to report improvement in both respects. Equally important, if not more so, my PSA continues to remain low and fairly stable as shown by the following data: March .365; April  .256; May .28.

The above good news is overshadowed by the events I describe in the following Patient Portal email to Dr. Myers: "By way of an update you should know that I have developed symptoms alarmingly consistent with Pca metastasis. These symptoms include acute pain in the lower left posterior of my rib cage brought about by vigorous physical activity (i. e., a competitive singles  tennis match). The pain has not subsided since its onset nearly two weeks ago. The affected area is fairly limited in size and scope, but is quite sensitive to pressure and movement. I have an appointment tomorrow with my family physician (a Pca survivor too).  I would appreciate any feedback you care to provide."

Dr. Myers responded  to my concerns  thusly: "Those would be very atypical for bone met symptoms, which rarely have an acute onset and rarely would be sensitive to touch. This is most likely a cracked rib.* A bone scan  and then an MRI of any abnormalities would be definitive." To which I replied: " Thank you so very much for the feedback. I could only hope that you might be willing to provide an opinion without having seen me. My doctor thought I did the right thing to come in for an examination because of my history. He arranged a total bone scan for  next Tuesday. I will keep you informed. Also, I will contact you regarding an MRI. You indicated when we last met that I should arrange a MRI screening prior to our next appointment."

Thankfully, the above exchange of emails drained the developing  drama of much of its momentum. Even so, as has been said in a great many contexts, "It's not over until it's over." Stay tuned.


*Comforting and plausible but wholly contrary to my online research effort.
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