Pet scan - 1259321

tasha
Posts:2

My husband was diagnosed with prostate cancer in June 2012. His biopsy got just one positive bite.
June 2013 after no treatment he did another biopsy, he was positive on four bites with a Gleason of 7.
One urologist said wait and only treat if needed one said treat now. Psa is 13.5, MRI and ct scan done in June said possible spread to bone in hip and spine but very small and not sure. Did a pet f18 it also said small non hyper metabolic lesions in hip and bone AND several hypermetabolic mediastinal and bilateral hilar lymph nodes consistent with metastatic adenopathy. Reactive hyper plastic adenopathy is a consideration. No lung nodule seen. The lymph nodes are between 1 and 1.2 cm with SUV between 7.0 And 8.3. Ventricular emphysema in both lungs. Bilateral calcified pleural plaques consistent with asbestos exposure. He was on a navel distroyer for five years in the 50's. started hormone treatment lady week. Doc suggested rescanning in three months! I have been resurching possibilities of lymph nodes could it be prostate cancer spread?
SOOOO CONFUSED

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Reply # - September 17, 2013, 12:17 PM

catdander
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Hello tasha, I'm very sorry your husband has been diagnosed with prostate cancer and hope the other findings are benign. It's common to feel confused and out of control. Cancer has its way with us all, even if the outcomes will be good, while we're in its grasp cancer can be ruthless. I'm sorry but at the moment we don't have a specialty in prostate cancer.

I can say that PET scans measure activity such as lymph nodes doing their jobs in the immune system to fight infection. Oftentimes the person may not even know an infection exists. I believe that's what's meant by "Reactive hyperplastic adenopathy". The following link is a primer on PET scans
http://cancergrace.org/cancer-101/2010/09/14/cancer-101-faq-primer-on-p…

Another thing to know when reading a scan report, the doctors reading the scans and writing the reports are noting everything they see and aren't "looking" for anything specific (Sometimes that includes a comparison to a previous scan or report). It's not unusual to have nonspecific features in the bones, sometimes a closer look can help but nothing can tell for sure short of a biopsy. Sometimes a biopsy just isn't feasible. I know, still confusing, right? It's not unusual for oncologists to want to "wait and see" for 3 months when looking into lung cancer issues. Perhaps this is the same idea. There's a lot of waiting and watching in cancer care and to tell the truth it's become a welcome phrase in my life, on and off the forum.

I hope all goes well moving forward,
Janine
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Reply # - September 17, 2013, 10:22 PM

Dr West
Posts: 4735

It's certainly possible that the minimally enlarged lymph nodes are from the cancer, but there isn't any specific treatment just for them. Instead, hormone therapy, whenever initiated, would likely work against prostate cancer cells wherever they are in the body, including in lymph nodes, in bone lesions, and/or any circulating cancer cells in the blood stream.

Because prostate cancer tends to follow a fairly indolent pattern of progression, it's unlikely that there would be any difference in outcome between starting hormone therapy now vs. later, when the overall picture is clearer.

Good luck.

-Dr. West

Reply # - October 1, 2013, 08:33 PM

tasha
Posts: 2

We just got his blood work back and his vitamin b12 is elevated to 1011, is this one more indication of bone metastasis?

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