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← Return to PET Scan or not yet?
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@surftohealth88
Quality of life is pretty significant. ADT is no walk in the park and that is why you are seeing a push to reduce the months on it. As said earlier this is about one’s individual cancer circumstances. A publicized Scandinavian study out of Denmark published in The Journal of Nuclear Medicine noted that researchers tracked nationwide, data collected over an eight-year period (2015 to 2023) to see if getting a PSMA-PET scan before salvage radiotherapy (sRT) actually translated to longer life. The study confirmed that men who received a PSMA-PET scan before radiation had a statistically significant improvement in overall survival (OS) compared to those who did not. Researchers evaluated 844 patients across Denmark facing biochemical recurrence after surgery. They compared patients who had a pretreatment PSMA-PET scan against those who did not.5-Year Overall Survival: The overall survival rate at 5 years was 98.1% for the PSMA-PET group versus 93.8% for the non-PSMA group.Reduced Mortality Risk: Patients who skipped the advanced scan and went straight to conventional salvage therapy had a 3.3 times higher risk of death during the follow-up period Recurrence-Free Benefit: The 3-year biochemical recurrence-free survival was also superior (74.9% with PSMA-PET vs. 69.4% without).Why the Scan Improved SurvivalAs noted by lead author Anna Mogensen from Aalborg University Hospital, the data suggests that PSMA-PET allows doctors to meticulously select the right patients for local radiation. If the scan reveals the cancer has already jumped to distant bones, doctors can pivot to systemic treatments, saving the patient from ineffective localized radiation while aggressively targeting the actual spots. Critics will argue this is just a small study, but the anecdotal evidence and preliminary studies are pointing this way. Since PSMA-PET is recent when looking long term, critics will also argue it is to soon to know. Personally having participated in clinical trials i know the benefit when looking at preliminary results and deciding whether to go forward as it is up to each patient to decide their course. The NCCU guidelines are guidelines based on prior studies, but before NCCU guidelines begin to account for a real change in their guidelines their has always been evidence pointing in that direction years before an actual change is made.
Replies to "@surftohealth88 Quality of life is pretty significant. ADT is no walk in the park and that..."
@wheel1
It would make a lot of sense that those that had PSMA PET scan scans would do better. That’s because some of them would have metastasis show up that could be zapped instead of doing salvage radiation right away.
Some of the doctors like Scholz and Kwon Believe in doing scans and waiting until something shows up and zap it. Instead of doing salvage radiation. They talk about it at the PCRI conferences Which you can find on YouTube.
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@wheel1
"The study confirmed that men who received a PSMA-PET scan before radiation had a statistically significant improvement in overall survival (OS) compared to those who did not. "
Did you mean to say "men who had positive PSMA scan" ?
I do not understand purpose of this study otherwise ? WHO in the world has salvage RT without first having PSMA done 😵💫 ?
Regarding official guidelines - I mostly read studies and make my opinion based on them. Unfortunately doctors are following "standard of care" and can not prescribe novel therapy unless it is approved. So yes, some things are outdated but some show very clear picture in randomized trails and from multiple institutions across the world. One of those is : early salvage (before 0.5) regardless of PSMA being negative with RT to the whole pelvic floor PLUS nodes , PLUS ADT shows much superior results for majority of patients.