Rut Roh Rorge - PSA wrong direction

Well…I’m off to PSMA PET scan. Maybe we should get a pool going.

Number of lesions identified - bone? _________
Number of lesions identified - lymph? _________
Number of lesions identified - organ? __________
Largest lesion in centimeters? __________
Maximum SUV? __________

1st prize = box of Cheerios

Aw,...C'mon you guys - that's funny 🤣🤣🤣

Well...got the results from the Liquid CDx. Need to do more research but there's a lot of...
"No therapeutic or clinical trial options".
Pretty sure that's not good.

I'll list the muts in my profile for those interested.

@mjp0512

Hang in there - when will the PSMA results come back? Then your Docs will finally let you know the next treatments! I hope they dont' keep you waiting. Crossing fingers its just one overactive metastasis - maybe that hip area you mentioned. Then they can quickly zap it and you can watch that PSA drop again.

@mjp0512

Hey mjp 💗 ! I am wishing you one single tiny met that is easily zapped and gone forever !!! 🍀
In the meantime, sending hugs and healing vibes your way !!! ✨

@klein505 - Thanks! Last one I had was done on Friday and results posted Sunday evening so I should see them before the end of the weekend.

@surftohealth88 - Thanks, surf. That would be awesome!

Wow, that was fast PSMA PET results 4/30/26:
_______________________________________
Impression:

Increased focal PSMA activity in the RIGHT apical prostate adjacent to fiducial marker since 6/6/2025. Decreased PSMA activity in the LEFT apical prostate.

Increased PSMA activity and sclerosis associated with L5 vertebral body osseous metastasis.

Interval resolution of PSMA avid metastatic lymphadenopathy in the pelvis, retroperitoneum, and mediastinum.

Narrative
PET/CT PSMA ILLUCCIX FOR PROSTATE TUMOR IMAGING

HISTORY: Oligometastatic prostate cancer, diagnosed in May 2025. Radiation therapy September-October 2025. On systemic therapy. Rising PSA level.

COMPARISON: 6/6/2025.

Findings:

Neck: No suspicious tracer avid disease.

Chest: No suspicious tracer avid disease.

Abdomen/Pelvis: Fiducial markers in the prostate gland. Increased focal tracer activity in the RIGHT apical prostate adjacent to a fiducial marker, max SUV 19.3, previously 11.1. Decreased tracer activity in the LEFT apical prostate, max SUV 7.8, previously 10.0.

Interval resolution of tracer avid metastatic lymphadenopathy in the pelvis, retroperitoneum, and mediastinum.

Bones: Increased tracer activity associated with sclerotic lesion in the L5 vertebral body, current max SUV 17.5, previously 11.9. Increased sclerosis since prior study. No new tracer avid osseous lesions identified.
__________________________________________________________
Not as bad as I thought it was going to be. Can probably zap the L5 lesion but I have no idea what's available for the prostate since it's already been radiated. Apparently, my RO wasn't a very good shot. It's pretty cool that everything else is gone, though.

@mjp0512
That is a real serious problem with your prostate. It does look like they did not completely zap what was there?

Yes, they can do the L5 for sure they did my L4. They wanted to do it in three sessions because it was wrapped around my L4 and they didn’t want to put it too much radiation on all at once.
Here are some answers about what to do for the prostate that is reoccurring. There are doctors that are trained in using surgery to treat prostates that have reoccurrence after radiation. I know the Mayo Clinic has many doctors that can do this. If you can’t get to them, there are other places that have doctors that specialize in doing that.

People who have radiation as their primary treatment have been told by doctors that surgery isn’t really an option if there’s a reoccurrence. Other options are not really mentioned..

This study shows that both salvage focal therapy (HIFU and cryotherapy) and salvage surgery were equally effective at extending the life of a patient that started off with radiation.

Those that had focal therapy had fewer perioperative complications.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2844900

@jeffmarc - Thanks Jeff and thanks for the article. I just finished reading another of similar topic from NIH...
https://pmc.ncbi.nlm.nih.gov/articles/PMC11651831/
I have zero desire, at this point, to have surgery so the medical brain trust will have to figure something out. I'm thinking SBRT to the prostate lesion may be an option. I've seen much higher doses of radiation given than I received. Maybe there's room for a little more?!?

@mjp0512
I would really be surprised to hear they would give you radiation to a prostate spot they’ve already Radiated. That’s usually a lifetime radiation dose.

Be interesting to hear what they come up with.