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Is PSMA PET scan used for staging?
I was recently diagnosed with prostate cancer. The biopsy returned positives in 3 clusters (equal): grades group 1, 2 and 3. My urologist is calling it Grade Group 3 and he is asking me to do a PSMA test for staging. I read that this test can return false positives (beging items) and many more other cancers. Does anyone have any experience with this. I am currently looking to get sec opinion.
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I am not a doctor, but using a PSMA PET scan for initial staging does not make sense. That scan only detects cancer cells that express PSMA, and does not detect other cancers that don't. It can't reveal "many more other cancers," as you put it. It seems like an MRI and a non-PSMA PET scan would be more useful because they can detect more types of cancer than just those cells that express PSMA.
What the doctor is trying to detect is if the prostate cancer has metastasized. If it has that will change the treatment plan. It might be a local spread to seminal or lymph nodes or more distal if anything is found. The doctors grading the test know where accumulations occur such as bladder that are not cancer. Actually, the PSMA is more likely to have a miss than a false positive. Since it is a scan from neck to mid-thigh they will report on any other abnormal or benign items they find. The grade group is always the highest one. Group 3 is a 4+3 which means that over 50% was Gleason type 4. Other factors would be how high your PSA was. Was anything else mentioned in the biopsy (EPI, Cribform, etc.) that indicates a more aggressive cancer.
Almost everyone with group 3 or above has had a PMSA PET scan if diagnosed in the last few years. It takes about 2 hours with the first hour waiting after the injection and about 20 minutes of actual scan.
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3 ReactionsThe radio tracer that you get is specific to prostate cancer cells. There are different types depending what your doctor is looking for. For instance with lymphoma a different tracer is used. I would not worry that it will find another cancer. The radiologist will see other organs that they will likely see and classify as unremarkable. The PSMA-PET is staging for everyone basically today after diagnosis to see if the prostate cancer has left the capsule or us found in your lymph nodes.
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1 ReactionThe PSMA pet test specifically tests for PSMA found in the body. There are a few places where it is naturally produced, and that is known. If you’ve had broken ribs, they can show a SUV but it is minimal.
You are actually getting the ideal testing. I would definitely want to get a PSMA PET scan before treatment to make sure there is nothing else found in the body.
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3 Reactions@lag thanks!
@jim18 the biopsy said "no cribriform". I also do not see EPI. I appreciate the explanation. Have decided to get it done and hopefully it will not reveal netastasis and I can proceed with SBRT. Thank you!
@jeffmarc Thank you! I truly appreciate the response!
I think getting a PSMA Pet would be good idea.
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1 ReactionYou didn't say your age. It is important to find out where the cancer is as soon as possible. PSMA is effective to locate where the cancer is. I will have one this coming August. I am 80 and my cancer is stage 4.
Good luck
66 yo. Thank you for sharing your thoughts. Wish ou all the best!