Hip Bone Metastasis: What treatment did you have?

Posted by florida11 @florida11, Mar 18 3:14pm

My last PET scan showed a "sclerotic lesion on my right acetabulum" measuring 1.5 x 1.5 cm (PSA was 0.18 and testosterone 37 at the time of the scan; I was coming off ADT from last year), which was an increase from my prior scan a few months earlier. Planning on 4 months of ADT and 1-day radiation treatment at Mayo. This is my 3rd reoccurrence (Gleason 4+3=7, surgery 12/17, radiation to prostate bed in 2018, radiation to lymph node area near abdomen in 2023). I had no pain until after receiving the PET scan results, then felt mild hip pain on the plane home in February and ever since.

I would welcome and appreciate if anyone has experience with hip bone treatment/radiation they can share (i.e., any noticeable pain, treatment, outcome, etc.)?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

northoftheborder | @northoftheborder | Mar 18 5:30pm

Sounds like a good plan.

I'm happy I had my spinal lesion radiated after debulking surgery. Some oncologists think that the primary cancer and big metastases provide support to help new, smaller metastases to develop, so treating them aggressively might help slow progression more generally (in his book, Dr Walsh calls that apprach "attacking the mother ship").

gently | @gently | Mar 18 9:05pm

Northoftheborder, did they advise zoledronate or Prolia.

northoftheborder | @northoftheborder | Mar 18 9:23pm

In reply to @gently "Northoftheborder, did they advise zoledronate or Prolia." + (show)

"Northoftheborder, did they advise zoledronate or Prolia."

Neither. A full-body bone scan* showed no other metastases, and things happened very fast for me: I was admitted to hospital on Monday with trouble balancing, was given a likely cancer diagnosis (unknown type) after an MRI on Wednesday, got a biopsy on Thursday, lost use of my legs on Friday from spinal-cord compression, and was on the operating table in the wee hours of Saturday morning for 10+ hours of emergency spinal debulking surgery to try to save me from permanent paraplegia (it succeeded, but it took a long time to get my legs back). I got post-op radiation to the surgery site 4 weeks later, and radiation to my prostate a few months after that. Otherwise, just ADT + Erleada (Apalutamide) have been managing my cancer.

No indications of other bone metastases since. I've lost a little bone density (not sure if it was before or after I started on ADT, because I didn't have a baseline), but nothing serious — regular weight training and calcium supplements help.

(* Note that a PSMA PET scan wasn't an option in Canada in 2021, because the maker of the imaging agent hadn't gotten final Health Canada approval yet; they always come to smaller markets like us a couple of years after the big markets like the U.S. and EU.)

gently | @gently | Mar 19 7:46am

Fascinating. Was the compression prostate spinal cord compression. And you were diagnosed with the cancer, had the biopsy and the loss of leg use and debulking surgery all in four days. Must have been insane. And it seems you have amazing doctors.
The US didn't get pylarify until May 2021. PSMA-11 was approved in 2020.
Do you dxa for bone loss yearly or at all.