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← Return to first PSA result post salvage RT — 0.086
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first PSA result post salvage RT — 0.086
Prostate Cancer | Last Active: Feb 15 6:22pm | Replies (9)Comment receiving replies
Brian, Many thanks for this information. Given the discrepancy between my PSA and SUVmax, I’ve suspected that there is something being missed in reading the tea leaves of the PSMA PET data. Perhaps this is it. Neither the radiologist who issued the report, nor my urologist mentioned anything about comparing against SUVs of different organs and blood. I will certainly bring this up with my RO and urologist, both of whom I will see in the next couple of weeks.
Do you have any references for these comparisons—journal articles, conference presentations, etc? Would be useful to share those with my docs.
I doubt that the nodule is residual prostate tissue. I had regular DREs following my RARP, as well as PSA tests. In the ninth year after my RARP, my urologist first detected a lump during a DRE, but my PSA was still undetectable (< 0.1) at the time, so there was no further action. It was a year later (June 2025) when my PSA rose to 0.11 that all the alarm bells started going off. I suspect that the recurrence is low grade cancer, but it sure would be good to confirm/correct that hunch with some actual data.
Replies to "@brianjarvis Brian, Many thanks for this information. Given the discrepancy between my PSA and SUVmax, I’ve..."
@melvinw As for the discrepancy between PSA and SUVmax —> Remember that a PSA is a hard number, subject to the calibration, sensitivity, limitations, and accuracy of the lab equipment used.
On the other hand, an SUVmax score (just as with a PIRADS score and a Gleason score), is a specialist’s educated and expert “opinion” of what he (or she) believes they see in an image, scan (or under a microscope) - it’s often as much an art as it is a science.
What one pathologist sees as a Gleason 7(3+4), another might see as a 6(3+3) and another see as a 7(4+3); what one might see as a PIRADS 3, another might see as a PIRADS 2, and another as a PIRADS 4. Similarly with SUVmax scores….
Additionally, PSA is not always tied to aggressiveness of disease. So, it’s not necessarily a “missed in reading the tea leaves,”; there’s simply no way to know who is right……
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@melvinw Dr. Johnson (of Mayo Clinic) talks about scans in his (hour-long) presentation, starting with the scans we’ve all heard about (MRI, bone, & CT scans), and then going into great detail about PSMA PET scans: https://youtu.be/JoJomACA5UM