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PSA levels at 4.3 to 4.8: Should I have a biopsy after MRI?
Prostate Cancer | Last Active: Nov 5 1:53pm | Replies (16)Comment receiving replies
@cadman2025 Be sure to get Decipher test, which checks for aggressiveness.
This score will determine whether you even need ADT at all.
Also, look at your biopsy report and see if it mentions things such as cribriform cells or intraductal carcinoma; these findings are less amenable to standard radiation treatments and may require a boost of single seed placement before five sessions SBRT.
All of these factors combined really do dictate the treatment these days. It is no longer simply surgery versus radiation - but surgery versus what type of radiation. And even what type of radiation with or without ADT.
I know your head is spinning since we’ve all been through it; but settle down and do a little homework and you will be much happier with your decision. Best,
Phil
Replies to "@cadman2025 Be sure to get Decipher test, which checks for aggressiveness. This score will determine whether..."
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@heavyphil
Thank you for your advice and help.
Here is the extract from my PSMA PET scan result today and what this SUV 4.6 in prostate Gland means?
EXAM: PSMA PET/CT VERTEX TO DISTAL THIGH
HISTORY
: Initial treatment. 66 year old male with C61 malignant neoplasm of prostate, unfavorable intermediate risk. Staging prior to treatment.. PSA up to 4.9.
PET/CT REQUESTED FOR
: Initial treatment strategy.
RADIOPHARMACEUTICAL
: 9.9 mCi F18 DCFPyL IV (PSMA)
TECHNIQUE
: This is a combined PET/CT scan. PET is performed from top of skull to knees after a 62 minute uptake phase. CT is performed without oral or IV contrast.
Physiological distribution of tracer is seen within the salivary glands and lacrimal glands, blood pool, liver, spleen, pancreas, ganglia, bone marrow, bowel, kidneys and urinary tract.
SUV reference:
SUV max parotid/salivary glands: 18.1
SUV max right hepatic lobe: 9.3
SUV max descending thoracic aorta: 1.3
PSMA - expression score:
High (3) SUV parotid/salivary glands
Intermediate (2) SUV liver
Low (1) SUV blood pool
THORAX: No increased uptake in the lungs or mediastinum. No suspicious pulmonary nodules. No pleural or pericardial effusions.
ABDOMEN/PELVIS:
Evaluation of prostate bed: There is a focus of abnormal uptake with maximum SUV of 4.6 in the posterolateral right lobe (slice 279) at the mid gland level. No involvement of the seminal vesicles.
Evaluation of lymph nodes: No increased uptake in pelvic, retroperitoneal, or abdominal nodes.
No increased uptake in the liver or spleen. Liver and spleen are not enlarged. No hydronephrosis. No adrenal nodules. Pancreas is unremarkable.
BONES/BONE MARROW: No increased uptake in the skeleton and no suspicious lytic or blastic lesions.
IMPRESSION:
1. PSMA avid malignancy in the right lobe of the prostate as above. No evidence for extraprostatic disease.
Thank you for the opportunity to participate in the care of this patient.