STAGING PROSTATE CANCER: IS IT UNNECESSARY TO GET A BONE SCAN?
Some doctors have suggested that if your PSA is less than 10, it’s unnecessary to get a bone scan. We don’t agree and, in fact, believe the bone scan to be valuable for several reasons:
For one, even some patients with low PSA levels (men with poorly differentiated tumors, for example) nonetheless have prostate cancer that has spread to bone. A bone scan could confirm this, or rule it out. Also, the radioactive tracer used for the bone scan is excreted through the kidneys, and this is a good opportunity to check the kidneys, and make sure the cancer isn’t causing any urinary obstruction.
Perhaps the strongest argument for a bone scan is that it provides an essential baseline. Say a man starts having severe back pain five years after being treated for prostate cancer, and a new bone scan shows a lesion. It is extremely useful to have an earlier bone scan for comparison, to see if the lesion has been there all along, or if its development is a new event and is something to be worried about. This may be the bone scan’s most valuable benefit. For these and other reasons, we believe all men should have a baseline bone scan when prostate cancer is diagnosed.
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