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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
@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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@brianjarvis Yes to all that. I’ve also read that because PSMA PET scans are so new that docs are still trying to get a handle on what the data are actually telling us.
The hard facts I have in hand are: (1) it was nine years after my RARP when a palpable nodule was detected; (2) it was ten years after my RARP when my PSA rose above detection for the first time (0.11); the nodule showed significant uptake on the PSMA PET scan; (3) three months after my PSA rose to 0.11, and just before starting RT, my PSA remained unchanged (0.11, Quest; 0.094 Labcorp ultra sensitive); and (4) three months after finishing RT my PSA is 0.086.
Summing all that up, I caught and treated my recurrence about as early as possible. In reality, if the SUV max was 3 or 8 or 10, I don’t think that would have changed the course of things one bit. I’ve said this before, but it was regular DREs that first signaled a local recurrence. A PSA of 0.11 (or 0.094) without a palpable nodule probably would have put me on surveillance rather than a course of treatment. There but for the poke of a finger…