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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 44379
Experience:  Board Certified Oncologist
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This is for Dr.David,A continuation from:- 06/08/2016 01:44

Resolved Question:

This is for Dr.David,A continuation from:- 06/08/2016 01***** David, Enclosed a copy of the CT Scan for your perusal and comments....:: Section reported by: DR D SALLOMI - CONSULTANT RADTOLOGIST ::: Verifi-ed: 23 May 20L6 L1:36 :::
Clinical- History : Raised pSA
::: section reported by: DR D sALLoMr - CONSULTANT RADro],ocrsr ::: Verified. 23 May 2016 Lt:36 :::
NM Bone whole body : Tracer within the bladder obscures ful-l- visualisation of the pelvis. Several foci of increased tracer uptake are noted in keeping with foci of degenerative change. Focus of soft tissue contamination noted. Smal-l focus of mild increase i-n tracer uptake overlies t.he l-eft seventh rib in its posterolateral margin. This is non-specific in sci-ntigraphic appearances and may be rel_.ated to trauma Foci of increase in tracer uptake overly the sternum. This may be related to degeneratj-ve change. Correlation with a l-ocalised plain film or crosssectional- imaging may be helpful to confirm this and exclude other causes for this appearance.
Impression:
No convincing scintigraphic evidence of widespread disseminated skeletal metastasis is identified on this isotope study. However, scintigraphic appearances of the sternum noted as described which woufd benefit from further eval-uation as described.
NM Sacroil-iac scan : PJ-ease see the report above.
Submitted: 7 months ago.
Category: Oncology
Expert:  Dr. David replied 7 months ago.

this is Dr. David

this bone scan report shows no evidence of cancer spread to the bones

but you have some old age wear and tear of your bones which is common at your age

that is what degenerative changes mean

Customer: replied 7 months ago.
O.k...So I will ignore the PET scan and go with the HT,RT,chemo? According to a senior oncology nurse,for the HT the drug that is injected is dependent on what the local surgery uses, should I specify a particular one, or does it not matter.
Expert:  Dr. David replied 7 months ago.

I would go with no estrogen patch

i would go with anti-testosterone therapy like leuprolide or goserelin which tends to be used over in europe.

pelvic radiation therapy for 5 weeks to treat the lymph nodes and cone down to the prostate to a higher dose

chemotherapy is questionable.

that is a good sign the bone scan didn't show evidence of cancer spread to your bones.

you are not getting surgery for your prostate cancer.

Customer: replied 7 months ago.
No one has mentioned surgery as yet.
Expert:  Dr. David replied 7 months ago.

you don't need surgery

choice of anti-testosterone therapy doesn't depend on your surgery.

leuprolide or goserelin are both fine to use to decrease and stop testoterone production to freeze any prostate cancer in your body and to make external beam radiation more effective

let me know if you have other questions.

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Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 44379
Experience: Board Certified Oncologist
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