PSMA PET Scans...some interesting info

It must be a real dilemma for doctors when a new technology like PSMA-PET emerges.

On the one hand, they don't want to miss a chance to help their patients in a way they couldn't before. On the other hand, they don't really fully understand the new technology yet, and especially not its long-term impacts.

Oncologists are humans like everyone else, and in the end, they're going to make intuitive decisions until there's a big enough body of research to let them make purely evidence-based ones.

@northoftheborder And on the third hand, they don't want to miss an opportunity to cash in and buy their own machine which mine did. That really muddies the objectivity water of which scan to use. The article stated there was no phase 3 study comparing survival rates performed which I find very interesting. Sometimes I feel it is better to not read these articles but southoftheborder we now have to advocate or many of our needs won't be met. Doctor's financial needs come first these days. Such is life. I will celebrate my so far successful BCR treatment and live my fullest life until one week jiggy time comes before my next PSA. Hope you are doing well.

@brianjarvis yes, good synopsis but again, if your BCR occurs before that ‘2 points above nadir’ you’d better hope and pray your PET will detect it…it might not.
I met a man about 3 yrs ago who had a recurrent PSA of something like 50…If memory serves he had had surgery and possibly SRT…he put himself on some very expensive ($20K/yr) diet and supplement plan involving coffee enemas instead of pursuing ADT therapy (can’t really fault him for trying).
When I asked him why he wasn’t getting radiation in some form he said, ‘Because they can’t find out where it’s coming from!’ Don’t know what type of scan they were using but some of the older ones (Axumin, choline) were even better in some ways than PSMA.
Oddly (or not) his PSA did drop by a large amount but I never saw him again to follow up.
I think there are always going to be outliers and anomalies in any cancer patient, regardless of the type. Best to you and my wishes for NO recurrence!!
Phil

I had two PSMA pet scans within 12 months. My first PSA was 1.0 and my urologist sent me for a psma pet scan . The only place that showed any activity was my sternum ,lit up like a Christmas tree. After I did my own research and a biopsy, which showed negative. Very rare for prostate cancer to metastasize to the sternum not likely. Anyway over the next 12 months or so my PSA continued to rise. my urologist said it might’ve been too low to pick up hidden areas. Almost a year later, my PSA is now at 2.8. We did did another PSMA test. The sternum still lit up(stable)in addition to one on the T7 region of my spine, mild suv, two lymph nodes one mild SUV and not sure because it doesn’t indicate just says has uptake. We didn’t do any biopsies. I had two opinions from radiologists and both agree to do SBRT. It’s the best way to go. And zap all four places. Although I believe the two spots in the bones are benign or negative. However, as they said it better to be safe than sorry. But I believe their decision and their thoughts to be what they believe based on my past history, and since this is probably a reoccurrence we didn’t do a biopsy. My oncologist wanted to put me on some type of ADT or a variation of. At the moment I declined. I read too many horror stories. I opted for SBRT at least for now. With only a few spots, it’s very doable and with the latest technology
PSMA pet scans are very sensitive and accurate when PSA is a little higher. Doctor Kwons sweet spot is between2 and 3for PSA. in the past any cancer found outside the prostate bed and prostate is considered metastasized and really, not curable however, this will change the treatment options and offer a cure for some. For others, this will buy more time till something greater and better comes along, hopefully, may God bless us all.

@whatthef Oh man, YOU are the exact patient we’ve been ‘hypothesizing’ about on this thread!
PLEASE keep us posted on your treatment and experience. Fingers crossed that your PSA plummets…
BTW, are they zapping the sternum as well?
Phil

@heavyphil Also, when they "zap" a spot, is that a one time shot or do you have to go in multiple times?

@dpayton Not sure in all cases, but usually 5 sessions…