PSMA PET Scans...some interesting info

Yes zapping the sternum as well.

@dpayton SBRT is 5 sessions usually at a much higher dose.

@whatthef good - kinda figured they would. In the absence of a previous injury, I guess the sternum is just as good a place as any for a PET to light up from PCa.
There’s a case I’m sure many have heard of where a patient had a large single metastasis to the clavicle. It was treated with SBRT and the patient remained metastasis free for 12 yrs; I read that study a few years back when my PSA started to slowly
rise.
That result gave me much hope…I don’t believe he had been given ADT either…Best,
Phil

Had 2 biopsies on the sternum. 1st was inconclusive, said there might be. 2nd biopsy confirmed negative. Between the 2 psma pet scans I also had 2 CT scans for other reasons. The last pet scan and the two CT scans showed the same sternum lesion as stable And no new lesions or increase in the sternum. it would also indicate a negative for pc. It’s Rare for prostate cancer to metastasize to the sternum and highly unlikely. Doctor said there may be some hidden there anyway, and since we’re doing the others, just zap the sternum same time. Also, the tracer used 18F etc has a significantly higher false Positive occurrences in the bones and ribs etc. verses the 68 Tracer. My concern with the sternum Radiation is the heart. Is directly behind the sternum however, my radiologist did the measurements concluded the heart would be out-of-the-way, especially with the breathing technique. I believe PSMA tests have opened another door for some people who have intermediate PC. And offer a long-term therapy verses adt. I’ll be finished with SBRT and two more days and then we’ll see. Hopefully, I’ll be able to report some favorable progress and news for other people. Take care and stay strong and may God be with you.

@whatthef . I started ADT , Firmagon, 8 weeks ago and have had 17 SRT fractions to my prostate bed and pelvic lymph nodes additionally. I noticed you said earlier that you didn't want ADT because of horror stories. I just wanted to let you know other than some additional fatigue I have had no other issues with ADT. Still playing golf, going to gym, etc. So if you decide in the future to try it, it may not be a big deal for you. Hopefully, I'll still be ok 4 months from now when ADT ends. Also, I have a lesion on my first rib that I will have zapped with SBRT after my SRT is completed. My SUV was 6.3. My Decipher score was .37 (low risk). Oncologist assumes cancer, but lesion was well defined and sclerotic in nature which can be either benign or cancer in appearance. The SUV is squarely in grey zone. I'm agreeing to SBRT only because I don't want to take a chance..... Very frustrating. Biopsy couldn't be done on rib and MRI was inconclusive due to breathing motion. Good luck in your treatment.

Thank you for your input on adt. I’ll definitely keep that in mind, good luck to you brother.

This explains why, after my husband's 2nd PSMA Pet scan, the doctor said it was good but it wasn't like AWESOME! He more gauges the process from blood work! and my husband first had CT scan and biopsies...
BUT after all that, the first PSMA PET scan, we only had the text about it and it sounded like he lit up like a Christmas tree, this second time it was much better, then a week or so my husband found the scans and we compared and WOW what a difference! a few spots still there, but not much compared to his body looking like he had chicken pox all over it on the scan!
Of course we're happy about it, but now it's terminal, so it's just a matter of how long the ADT will last...

@beaquilter wrote "Of course we're happy about it, but now it's terminal, so it's just a matter of how long the ADT will last..."

I don't remember the specifics of your husband's diagnosis (and am not a medical professional in any case), but ADT is just the first treatment, not the last. And I forget: is he taking an ARSI like Nubeqa or Apalutamide along with the ADT? Studies like TITAN have shown that starting those at the beginning of treatment instead of waiting for ADT to fail dramatically prolongs the period of castrate sensitivity for many people with metastatic prostate cancer, to the point that TITAN never reached median overall survival (too many participants in the study group were still alive, which is a nice problem to have 🙂). Obviously, it would be a discussion with the oncologist.

@northoftheborder Thanks for this knowledge . I never knew this ! excellent to know that IF you get put one One ADT drug , there are other combinations that can extend the useful period of the ADT itself . Do I have that right ? If ADT fails what is the next thing one could do ? I have a friend from my PC support group that he says his ADT failed and he has only been taking it for a year . He said "it started to fail" . I offered to take him out for coffee or a Pint , but he was too emotional to go at the time. we plan to meet next week. Can I mention soem things to help him as he makes notes for his Dr's visits about this ADT failing ? I sure would like to give him some things to be hopeful for .... Thanks for the help . James on Vancouver Island .

@beaquilter Quilter- I think you will be surprised at how many other options there are when ADT starts to fail , IF , it does . There is a whole "war chest" of options that are now live options to ADT failure . Amazing how PC treatments have developed . I would get a second opinion from a Urologist . Pick a urologist that has many forms of treatment and is considered best in area of study ! Keep us in the loop Miss . God Bless to you and your husband Miss . James on Vancouver Island .