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Anyone had the same? PC - Micrometastatic recurrence | PSMA PET neg

Posted by darrenh05 @darrenh05, Nov 26 9:46am

Just had a detectable PSA rise to 0.09 after been undetectable for 1.5 years after surgery & IMRT + ADT (46 year old). PSMA PET showed no signs of uptake. Gleason 7.
Drs are confidant it represents early recurrence. We are going to MSK for further consultation next.
I would like to hear of any similar cases from you. Specifically, what were your results with:
-Radiation: entire pelvis/nodes? SBRT versus IMRT?
-Medication: ADT + ABIRATERONE? (Strongly considering this for 2 years).
-Germline genetic testing?
Thank you.

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Profile picture for chippydoo
chippydoo | @chippydoo | Nov 28 6:46pm
In reply to @dpayton "@chippydoo Gleason 9 here too, Chippy. I also heard wait until PSA of 2.0. Just got..." + (show)
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@chippydoo
Gleason 9 here too, Chippy. I also heard wait until PSA of 2.0. Just got my last Eligard shot a month ago and my PSA is currently < .01 so all is well now. I'm not sure I want to wait until 2.0 with G9 but if the PSMA can't find anything what do ya do? My post RP PSA got up to .9 and the PSMA said I was clean but the bed area was categorized as (intense) whatever the heck that means. That's when my Eligard started.

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@dpayton No radiation to go with the shot? What is their plan? Seems prostate bed radiation would be incorporated with your ADT treatment. I found the following explanation- An intense uptake in the prostate bed on a PSMA PET scan indicates a high level of PSMA expression, which is typically associated with prostate cancer cells. This suggests that the prostate bed may contain significant cancerous tissue. The intensity of the uptake is measured using the Standardized Uptake Value (SUV), with higher values indicating more aggressive or significant disease. In the context of a PSMA PET scan, an intense uptake suggests that the cancer cells are likely to be present and may require further investigation or treatment.
Mayo Clinic

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dpayton | @dpayton | Nov 28 7:25pm
In reply to @chippydoo "@dpayton No radiation to go with the shot? What is their plan? Seems prostate bed radiation..." + (show)
Profile picture for chippydoo @chippydoo

@dpayton No radiation to go with the shot? What is their plan? Seems prostate bed radiation would be incorporated with your ADT treatment. I found the following explanation- An intense uptake in the prostate bed on a PSMA PET scan indicates a high level of PSMA expression, which is typically associated with prostate cancer cells. This suggests that the prostate bed may contain significant cancerous tissue. The intensity of the uptake is measured using the Standardized Uptake Value (SUV), with higher values indicating more aggressive or significant disease. In the context of a PSMA PET scan, an intense uptake suggests that the cancer cells are likely to be present and may require further investigation or treatment.
Mayo Clinic

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@chippydoo
Thanks for getting back. I left that part out. lol. Yes, I had radiation(prostate bed) 3 weeks after starting eligard. I’m about 12 months in on a 18 month ADT plan. Hopefully it zapped em all but so Gleason 9 you just never know.

Thanks for looking that up!!!!!!

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jeff Marchi | @jeffmarc | Nov 28 7:42pm

3 1/2 years after surgery my PSA started rising so they gave me salvage radiation for about eight weeks. 2 1/2 years later, my PSA started rising again and I was put on Lupron. 2 1/2 years after that, my PSA started rising again, which showed I was castrate resistant. I was put on Biclutamide for A little over a year and then Zytiga.
2 1/2 years later I went on Orgovyx and Nubeqa. I’ve been undetectable for 24 months. I’ve had it for 16 years and I’m now 78. I was a Gleason 4+3 Which is not too aggressive .There are a lot of great treatments, You have many years to look forward to.

I got prostate cancer at 62. The reason I got it was my father died of it and I got the genetic disorder BRCA2 From my mother. My brother did not get BRCA2 and got it at 77 because of my father.

Good to hear you’re going to get genetic testing to find out if it could be a factor. Getting it so young can frequently mean you have a genetic problem. Does anybody else in your family have cancer? You can get it here for free, takes 2 to 3 weeks to get the results and a genetic counselor will call you. They will send you a kit that you return in the mail. You have to live in the USA to get this test for free. Hopefully your doctors are doing it sooner and you don’t need this information.

Prostatecancerpromise.org

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