Tuesday 10 August 2010

Well you've had it easy for the past few days so now back to some serious stuff :-)

Firstly good luck to my brother Paul, he is going for his first consultant appointment today in Urology. He once said to me, "the good thing about having an older brother is that I can watch and see what is happening to you, knowing that it will probably happen to me four years later". Well I hope you are wrong with this one mate, but even if not you will have been caught very early and that seems key to survival in all this.

The appointment for my 'radionuclide bone scan' arrived this morning. I have to go to the 'Nuclear Medicine' unit at Carlisle Infirmary on Thursday. The information is nice and clear and I have to inform them if I intend to travel within a week, because the radioactive dye that they are going to inject into me will set off the security scanners! This is done as soon as I arrive, I can then walk around Carlisle for three hours to allow the dye to settle in my bones. If I meet you, don't shake hands! I then go back and the gamma scan takes just 20 minutes, the results going to my consultant for feedback to me on the 24th July. This is the third and final stage of assessing what to do as far as treatment is concerned. As you may remember the first stage was my PSA level which was 4.2. This was considered low and I wouldn't have even been referred except that my Father had died of this. The second stage was the Gleason score (growth rate) after the biopsy. Mine was 7 which is in the moderate bracket, 1-6 being low and 8-10 being high. Once the bone scan results are through I will fall into one of the sections below.

T1 - The tumour is too small to be seen on scans or felt during examination of the prostate (biopsy may find it)
T2 - The tumour is completely inside the prostate gland - T2 tumours are divided into 3 smaller groups
T2a - The tumour is in only half of one of the lobes of the prostate gland
T2b - The tumour is in more than half of one of the lobes
T2c - The tumour is in both lobes but is still inside the prostate gland
T3 - The tumour has broken through the capsule (covering) of the prostate gland
T4 - The tumour has spread into other body organs nearby, such as the rectum (back passage) or bladder.

The most likely bracket for me right now is T2c because biopsy showed that the cancer was widely spread within the prostate, 8 out of 10 samples reflected this. But then the MRI showed that the cancer was still within the prostate which is good.

I take some encouragement from a report on a bone scan research trial involving 631 men that I found online yesterday. Part of it's conclusion was......

'Although radionuclide bone scans are frequently recommended as part of the staging evaluation for newly diagnosed prostate cancer, most scans are negative for metastases.'

'Out of 308 patients in the trial with a Gleason score of 1-7 and PSA less than 50, only 3 had spread to the bone. My PSA was 4.2 and Gleason score 7.'

'Out of the same group, 237 who had a PSA of 15 or less, none, yes...NONE showed a spread to the bone.'

So I would have to be a very unlucky guy to fall outside these statistics, don't you think?

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