Thanks for sharing your number. To be clear, I am a two-time PCA patient currently undergoing salvage radiation and ADT. I can’t give true medical advice, just my personal opinion which includes my recommendation that you always seek the best pair care possible at a center of excellence.

I have had 2 PSMA PET scans at two different centers of excellence. I have been told by two separate oncologist that the scan does not have the resolution to detect microscopic disease. The lesion or lesions need to be about 1 cubic centimeter in volume to be reliably detected using the scan. In certain circumstances, it may be able to detect PCA with smaller volume disease, but that is not guaranteed.

You did not mention whether or not you had any other diagnostic tests. If that’s the case, I would suggest you consider having either a PSA 4K test or a PSAISO test as your next course of action. That can help you understand your risk of PCa in light of your current PSA number. If either of those tests come back with a significant risk of prostate cancer next reasonable test prior to having a biopsy would be a 3 Tesla MRI with and without contrast. If the MRI shows likelihood of an extraocular extension in the area of the prostate bed, then it is more likely that the prostate bed is involved.

If the MRI shows areas of suspicion and results in a PIRADS score of 4 or more, an MRI guided fusion biopsy would be the next logical step.

The PET-PSMA test is a great tool and probably the best tool currently available to diagnose prostate cancer and determine whether or not it has spread. It’s also an expensive test with a typical list price of $10,000-$11,000. As one can imagine, Insurance doesn’t want to pay for this test unless there is convincing evidence that the risk of spread beyond the prostate is highly likely.

Good luck on your journey and don’t hesitate to ask more questions if any of us can help you