PSMA scan

Posted by mal1 @mal1, Jun 14 5:54pm

I had a RP 1 year ago. Margins were clean. My PSA has been tested every 3 months. I have gone from .012-.026-.049 to .070.

My Doctor has odered a PSMA scan. I am trying to find out if my PSA is too low for a scan right now. Not sure it will show anything

Thanks

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mal1,
Ga-11-PSMA PET/CT outperformed 18F-flucicolvine at across all assessed PSA cutoff levels:

PSA 0.2 – 0.5 ng/ml: 46% versus 27%
PSA 0.51 – 1.00 ng/ml: 67% versus 28%
PSA 1.01 – 2.00 ng/ml: 67% versus 17%
https://www.urotoday.com/library-resources/imaging-center/139875-the-current-landscape-of-psma-pet-imaging-in-prostate-cancer-evaluating-men-with-biochemical-recurrence.html

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PSMA PET scans regularly out-perform older scans (like F18-Fluciclovine, C11 Choline, F18-NaF, and F18-FDG).

However, there is a relationship between PSA level and sensitivity of the PSMA PET to detect prostate cancers. Though different trials have had slightly different results, the lower the PSA, the more likely the PSMA PET scan is to miss prostate cancers. (See attached chart.) So, doctors generally want to wait until PSA is between 0.20-0.40 before they give a PSMA PET scan that otherwise might result in a false negative.

So, with your 0.07, if the PSMA PET scan doesn’t see anything, that doesn’t mean that no prostate cancer is there. It simply means that the PSA was so low that the PSMA PET wasn’t able to see it. On the other hand, if the PSMA PET does see something, then you were one of those very few that it worked for at such low PSA levels.

Good luck!

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Totally agree with Brian - my Dr at Sloan said that even at .2 it might show nothing but they would initiate salvage radiation even with a negative PSMA.

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Prostatectomy in Dec 2022.
01/27/2023 - 0.66 PSA
02/10/2023 - 0.803 PSA Re-Check
03/29/2023 - 1.28 PSA - Prescribed Orgovyx and 35 Radiation treatments.
08/31/2023 - 0.014 PSA - Post radiation.
11/21/2023 - 0.014 PSA - Orgovyx completed 11/3/23
03/12/2024 - 0.80 PSA - Test again in 3 months.
06/03/2024 - 0.445 PSA - Scheduled PSMA PET Scan 6/19.
Hopefully the scan detects something to treat. I think the next step is to treat using ADT with something combo. Might try to delay treatment until mid august if possible/advisable (travel plans).

Would be interested to see if anyone has experience/recommendations with holistic or herbal treatment options.

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Had my third scan yesterday after PSA hit 1.05 in May.
Finally found something. Other scans were negative when my PSA was below 1.

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I had radical protectomy 5 years ago, and shortly after found start of kidney cancer in right kidney that was not there 2 months previous in scans. had 35 sessions of targeted radiation and for 3 years psa was 0 . however in the last 2 1.2 years psa has started at .1 then .2 then .4 and until today it is 2.4(last 2 tests were the same 2.4 and maybe has started to level off. Had a PSMA Pet and they think that there may be residual in the bladder bed, which is a site that was the targeted radiation area and they do not advise radiation given in the same place. Has any one had a similar experience. i have no symtoms other wise

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@aed22655

Prostatectomy in Dec 2022.
01/27/2023 - 0.66 PSA
02/10/2023 - 0.803 PSA Re-Check
03/29/2023 - 1.28 PSA - Prescribed Orgovyx and 35 Radiation treatments.
08/31/2023 - 0.014 PSA - Post radiation.
11/21/2023 - 0.014 PSA - Orgovyx completed 11/3/23
03/12/2024 - 0.80 PSA - Test again in 3 months.
06/03/2024 - 0.445 PSA - Scheduled PSMA PET Scan 6/19.
Hopefully the scan detects something to treat. I think the next step is to treat using ADT with something combo. Might try to delay treatment until mid august if possible/advisable (travel plans).

Would be interested to see if anyone has experience/recommendations with holistic or herbal treatment options.

Jump to this post

6/19/2024 - PSMA PET Scan result - No radiotracer avid metastatic disease.
Next followup with urologist at the end of this month. Have an appt with a holistic doc next week. I feel I need help to get my body ready for the fight.

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