Medical Q&As

Prostate cancer - bone secondaries?

Is it possible to have bone secondaries in a man who has undergone prostatectomy for cancer of the prostate even though his PSA is less than 0.1? I am enquiring on behalf of a man who has symptoms that are suggestive of bone secondaries. He is very worried and is currently waiting for a bone scan.

PSA stands for prostate specific antigen and the PSA test has been addressed in a previous Ask the Doctor question. The test is used for screening purposes in relation cancer of the prostate but it is also used for routine follow up in those that have been treated. A PSA of less than 0.1 ng/mL would be regarded as low and would tend to out rule the possibility of recurrence but in view of the symptoms you mention it is prudent to perform a bone scan. Doctors are generally reluctant to rely on one test for the purpose of excluding the possibility of a cancer recurrence hence the need to obtain a bone scan. Given the figure you quote it is likely that the bone scan will be clear but this needs to be confirmed.