Hi,
The tests that are required during staging cancer are indeed based on the PSA and the Gleason score. For low
levels of PSA and low grade Gleason, the chances of having bone disease is indeed low. These assumptions are
of course predicated on a situation where there are no symptoms such as bone pain.
Consider then if there is anything that can explain the pain (if the kidney stone is indeed on the side of the
abdomen where the pain is elicited, this may indeed account for it; the numbness on the pinkie and the side of
the elbow sounds like nerve compression, this commonly occurs without considering bone metastasis for example
if you’ve ever banged your elbows and felt an electric like shock along with transitory numbness, this is
because nerve that runs down the side of the pinkie is anatomically near the skin along the elbow; the pain in
the lower back may indeed be due to moving furniture; the pain in the hip is a tough one to evaluate
especially since bone metastases tend to involve these areas, the value of a thorough physical and neurologic
examination may go a long way).
If the symptoms are not adequately explained by findings on the examination which lead to other conditions
independent of metastasis, then an investigation with a bone scan is probably the best way to go.
