Inconclusive Bone Scan in Men with Intermediate and High-risk Prostate Cancer: What next?

Abstract

To evaluate the incidence of inconclusive bone scans and down-stream imaging and clinical follow-up generated, including subsequent treatment outcomes in men affected by inconclusive bone scans with intermediate- and high-risk prostate cancer. Retrospective study of clinical data for a Scottish population of men diagnosed with prostate cancer in the intermediate and high-risk groups. Of the 1,246 patients included, initially 81 men were identified as having an inconclusive bone scan result following multidisciplinary team discussion. After further imaging, 24 patients remained inconclusive for metastasis. Of these, two patients received no treatment; one because of a watchful waiting decision, and one because of death. Of the 13 patients receiving radical treatment (laparoscopic radical prostatectomy or radiotherapy), three patients showed relapse (23%) indicating presence of microscopic disease and failure of radical treatment alone for these patients. This paper will assist nurses and multidisciplinary team members in understanding how patients diagnosed with intermediate- and high-risk prostate cancer with inconclusive bone scan results are subsequently imaged and managed in the current health care system. This raises awareness amongst nursing staff of disease recurrence and the possibility of downstream multimodality treatment for these men with inconclusive bone scans.