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Cancer: Prostate Message Board
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Old 06-13-2008, 08:52 PM   #1
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CAT scan vs. bone scan for diagnostic tool

Hello everyone.
My father, who is almost 94, is dealing w/ prostate cancer in its more aggressive state at the moment. Since 2004, he's gone through a couple of hormone treatments, several radiation treatments and has been almost totally asymptomatic throughout. I mention this because I wonder if that fact may have contributed to something that occurred this past couple of weeks.

A standard procedure my father has been undergoing is a bone scan every few months. We were told it was to reveal any attack sites of the prostate cancer once it left that gland, since that was the place of highest predictability of attack. A couple of weeks ago, his bone scan revealed a "spot" of more than a little interest to his oncologist. The doctor ordered a CATscan at that point to get a more detailed look at what had caught his eye in the bone scan results. He also had a biopsy done.
A few days later, we were told the results were a lytic lesion of a very aggressive nature. There was no mention of the size of the cancer. My father was referred back to the radiation specialist. In our consulation w/ him, we found out for the first time that the "spot" on his pelvis was really a massive tumor that had eaten away the upper surfaces of his pelvis and even encroached into his abdomen. My family and I were dumbfounded. When we asked how this could happen w/ their steady care over the past few years. we were told the bone scan doesn't reveal the same detail as the CAT, and that was how it got by them.
If the attributes of each type of scan are known, is it common practice to use the lesser detailed of the two for monitoring the health of a cancer patient's bone? My father has jumped through all the hoops for the past several years, thinking all these bonescans would reveal the initial phases of any bone attack site, so that it could effectively be treated w/ appropriate radiation while it was small. The radiation doctor says the tumor is too large to treat in a meaningful way now.

Is this type of care common in the cancer world? Did someone drop the ball here or did we expect too much from the care my father was receiving?
Maybe having no symptoms of the cancer (no pain), caused the primary oncologist to overlook more detailed dianostics in favor of more routine monitoring. We are at a loss.

Thanks for any feedback anyone can provide. We feel we are living through a nightmare.
Tim

 
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