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Why does PSMA Pet Scan show no evidence of mets? Missing something?
-PSA of 7.
-MRI May/2025 PI-RADS 5, suspicious for extraprostatic tumor extension, suggesting neurovascular bundle involvement. No lymphadenopathy.
-Biopsy June/2025 - Right posterior medial Gleason 3+4, grade 2, pattern 4=40%, involving 3mm (30%) of 1 out of 2 cores.
Right posterior lateral Gleason 4+3, grade 3, pattern 4=80% involving 5mm (70%) , 4mm (40%), 0.7mm (< 5%), 3 out of 6 cores.
PSMA PET Scan July 2025 - No evidence of any Illuccix avid prostate uptake. 3 small lymph nodes demonstrating mild uptake within the upper abdomen. these represent reactive lymph nodes since no abnormal lower abdominal or pelvic lymph node activity uptake
is identified. No evidence of any Illuccix avid osseous metastatic disease.
I Guess PSMA Pet Scan is good news but I don't understand why no uptake in prostate based upon PSA, MRI & Biopsy? Worried we missed something.
65 years old, Started Orgovyx 11/1 and had SBRT x5 just to prostate around Thanksgiving. Doing great with no side effects (yet). Very active strength training regiment. PSA now 1, Testosterone 10.
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@climateguy is there a test that one can take to see if they’re PSMA negative?
@sriddle1
There is no specific test for PSMA, a PSMA PET/CT scan is the primary test to see if prostate cancer cells are expressing PSMA (Prostate-Specific Membrane Antigen), revealing if they're "PSMA positive," but if the scan shows no significant tracer uptake, it indicates a PSMA-negative status. Other scans like FAP-PET or FDG-PET might be used as alternatives to find aggressive cancer cells that don't show PSMA.
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1 Reaction@sriddle1 this is a GREAT question. Understanding the genetics of our cancer cells and their rate of mutating would be extremely valuable to know BEFORE things blindly progress to an overly aggressive stage. It’s one of my primary questions that I hope to find an answer to.
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2 ReactionsJust want to comment that a bunch of you guys are real smarty pants in this discussion, dealing with some pretty arcane stuff!
@sandguy some of us are just doing the best we can to learn how to best treat what we have. Comments are sometimes imperfectly phrased and our knowledge is definitely not professional-but the intent is to learn, share and encourage.
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3 Reactions@middletown, how are you doing? Any update?
@colleenyoung, doing great. So far. Adapting to very minimal side effects.
Holidays have emphasized importance of diet and strength training. Can’t wait to get back on my regular routine.
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1 Reaction@zmarkv
Oh Jeez! It sounds like maybe you took my comment as being sarcastic or derisive, but no, I was intending that as a compliment!
I totally admire smarty pants!
Sorry, I guess it was ME who imperfectly phrased that, certainly not meaning to step on anybody's toes!
Terrific discussion, mucho respeto!
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5 Reactions@sandguy It’s something I’ve been known to do, especially when fishing for information in water that is way over my head. My goal is not to live forever (on this earth) but for my wife & family to know that I gave it a solid effort and didn’t just blindly follow the herd, Thanks for your reply!!
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2 Reactions@sandguy FYI Sand, I got it. Old tech has its place.