What Do The Following CT Scan And MRI Report Indicate?

Posted on Thu, 23 Feb 2017

Thu, 23 Feb 2017 Answered on

Sat, 11 Mar 2017 Last reviewed on

Question : I have a 72 year old uncle who has been told by two doctors he has cancer. He has a CT from first Dr an MRI from second Dr. He has been taking marijuana oil for two months but he can't get them to tell him if there is any difference from beginning till now. They both wanted to do radiation one proton the other something different. As of now there are 4 spots on left side of prostate largest spot 10 mm. Is it possible to get a independent Dr to look at his film and reports telling him if he is better same or worse since first diagnosed.

Answered by Dr. Indranil Ghosh (2 hours later)

Brief Answer:
Watchful waiting is also possible in prostate cancer

Detailed Answer:
Hi
Thanks for your query.

The PSA seems to have reduced, whether because of marijuana oil or on its own that is debatable. But it appears that he has got an indolent form of disease. What is the XXXXXXX grade on the biopsy? It will be mentioned on the biopsy report.

If it is a low grade cancer with PSA not rising and repeat biopsies done periodically does not show high grade cancer, then watchful waiting is one strategy. Delaying the treatment till absolutely necessary. You can discuss with his doctors regarding this.

Surely you can take opinion of an independent doctor regarding his disease status over time.

Hope this helps
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (26 minutes later)

thanks for the quick response. his real question is since the first CT scan is he better worse or same. medical marijuana is new for him but if it works versus radiation or surgery he would just rather take the oil although he's not a huge fan of the feeling. he is extremely outgoing person so oil puts a damper on that. but where do we find an oncologist that will look at two different DR's reports an film an say better same or worse from the first film. he fears some DR's may be against his alternative medicine. if a independent says to him your the same or worse an you should go for the surgery or radiation he would probably be ok with it as long as they don't say they are against the thought of cannabis oil doing anything. then he would think they being biased. if they say your better than you were he may elect to go longer with cannabis treatment. until they say it's not getting any better. anyway do you have any suggestions or referrals. thank you for your time

Answered by Dr. Indranil Ghosh (5 hours later)

Brief Answer:
Scans alone not sufficicent to monitor early prostate cancer

Detailed Answer:
Most important parameters to look for when such a patient is observed without treatment (or on alternative therapy) are PSA, examination by doctor's finger in rectum and biopsy every 6-12 monthly. Scans may be added as supplement but never should response assessment in such a patient be done on the basis of scans alone. That too comparison between CT and MRI is difficult. If both are CT or MRI then better.

I really can't vouch for any doctor who will make such comparison but surely you can explore someone. I see that you are in Oklahoma state. In that case you can contact Dr XXXXXXX Heinlen at Oklahoma University.
https://www.oumedicine.com/urology/our-physicians/jonathan-heinlen-m-d

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar