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Has anyone had the PSMA-PET scan? Was cancer found?

Prostate Cancer | Last Active: Feb 4, 2023 | Replies (133)
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@web265

I don't think I answered in this thread yet...but for the sake of more information...

PSA 11 at discovery 13 just prior to RP, Gleason 4/3, 8 of 12 cores, RP in Sept of 2021.
Margins clean, right pelvic lymph removed & tested clean (most cancer on that side of the prostate), minimal invasion in blood vessels and nerve tissue.
PSA 3 mos later <.2
PSA 3 mos later 0.039
PSA 3 mos later 0.091 off to the radiation oncologist.
PSMA PET CT ordered by urologist at that time.

PSMA PET CT showed nothing, which I guess is a good thing? Started 40 IMRT sessions (around #10 now) and orgovyx (Lupron substitute). It seems to have the same side effects they just don't seem as extreme as I see for Lupron, or, I'm just lucky enough to tolerate it better, who knows?

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Replies to "I don't think I answered in this thread yet...but for the sake of more information... PSA..."
drj | @drj | Jul 22, 2022

Some things are still uncertain.

PSA = or < 0.1 -0.2
Depending how the RP is done, e.g. nerve sparing, could some prostate tissue be left behind? I recall a discussion amongst four urologists on what to do with someone with PSA levels like this. One replied: I always ask the pathologist if they saw the prostate capsule membrane in the prostate that was removed. The implication is if they don't see it, some tissue could remain which might account for the tiny amounts of PSA. The key is looking for rising levels. I don't have enough information to determine if the PSA is rising.

Next: What is the reproducibility of the laboratory's PSA method at such levels? Are 0.04 and 0.09 truly different? I suspect these levels are analytical challenges, You would have to run both specimens in the same assay to be more certain. If the lab runs a QC specimen in this range, the analytical range should be known.

PSMA PET. Mine showed all cancer confined to the prostate. I hope it is true. On the other hand, what do we know about the analytical detection level of a PSMA PET for prostate cells? Perhaps it has been studied; I don't know. This is very new technology. One thing I'm fairly certain of: a negative PSMA PET does not rule out extra capsular disease. It likely only gives you probabilities of disease/disease free, neither of which has likely been established yet.

BTW, I chose radiation rather than RP. That decision too is a bit of a crap shoot as far as disease is concerned.

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