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Mestatic
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CWCWC posted:
Hi, I just posted below but was unclear as to what my concerns were. Given the (below) circumstances, how likely is it that I now have cancer in my arm/shoulder? I will paste in below what I wrote before, sorry for the repeat: (and thanks for the great responses I already got!)
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Dr., a quick history. I am 52, excellent health except PC. Discovered through biopsy August 2011. Gleason score 8 (4plus4) with a psa of 8.6. I have very much confidence in the Dr. I have. Late in September 2011 I had a bone scan and a CT scan, both clear. Beginning October I began a 5 month run of Lurpon, and simultaneously 22 external beam treatments. In December (early) had brachytherapy, the Dr. was very pleased. PSA down to .3 at this point. I developed some shoulder pain in mid November, it never went away and the last few weeks it is worse, with pain floating down my arm as well. It can be lessened with ice and ibuprofen, but really kicks up at night. My deductible began again this year, I am on a (very) limited budget. My Dr. says he feels it is not mestatic, and is just a strain (makes sense since my muscle structure is very sparse to begin with and the Lupron has left me weaker, no doubt). What is best course of action to consider, I have tried massage and chiropractic. I play a musical instrument and use my left hand in a strange position (I am taking a break) and have had some problems with this shoulder before. But, I can't help but be concerned. Any perspective on this? Thanks!
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Fairwind responded:
With a PSA of only 8.4 and a clean bone scan, your shoulder pain is much more likely to be arthritis than PC.. Have you had the shoulder X-rayed?
 
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Basir U Tareen, MD responded:
This should be a fairly easy enough question to answer with a bone scan. Without knowing your whole history and seeing all the previous information I will tell you that it is very unlikely to have an isolated arm metastasis -- especially in light of such a low psa.
 
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CWCWC replied to Basir U Tareen, MD's response:
Thank you so much Doctor, this puts me more at ease. My psa came back, this month down to .1 I think I will hold off on the (expensive) scans for now. I really appreciate your weighing in on this, it is invaluable. THANK YOU!
 
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CWCWC replied to Fairwind's response:
Thanks! I had a low power xray at the chiropractor and he didn't see anything, but of course the gold standard is the bone scan. I am now down to .1 psa. I am going to hold off on a scan (financial reasons). Thanks for the insight!!!!