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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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@jondoetx

I was diagnosed with PC in Dec 2021. Gleason 9. PSA with Avodart 6.37. Stage T1a. Cancer invaded seminal vesicles. Had RP March 2022. Margins clean. PSA <0.05 (lowest blood lab can go), so determined undetectable. Have had 3 PSA tests since surgery and all <0.05. Did Pelvic CT and bone scan. All clear. Doing 39 rounds radiation now. Decipher score high. Asked Doc for PSMA. He said not needed. PSA test is better and bone scan clear. Should I go the extra mile and get PSMA pet scan? Redundant? Even if insurance won't pay, worth it? I want to be as sure as I can.

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Replies to "I was diagnosed with PC in Dec 2021. Gleason 9. PSA with Avodart 6.37. Stage T1a...."
jondoetx | @jondoetx | Dec 8, 2022

Correction, stage pT3b.

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melcanada | @melcanada | Dec 8, 2022

Similar circumstances I would wait on pet scan when and if PSA rises

39 rounds 2018 on zolodex but took me off 2 years

4 years later castrate sensitive metastatic in L2 and T12 Had radiation Stage 4 no cure but can control they say

I has L2 lumbar nuked 1 inch pc out On Zolodex to stop testosterone the fertilizer of pc

Covid shots can throw off PSA tests Wait 3 months

My PSA 1.2 for years then 4 5 6 Just had bone and ct scans Results Monday 12th

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drj | @drj | Dec 8, 2022

I think the better question might be: should you go on ADT, not run a PSMA PET. With seminal vesicle invasion, I suspect the answer is yes.

I agree with the doc. His question on PSMA PET revolves around: would that alter the treatment? I think the answer is "no". I suspect you are receiving optimal treatment now. Once outside the prostate "bed", the places the PCa would go might not be amenable to localized treatment.

Consider this. My PSMA was clear. Does that mean I do NOT have mets somewhere? Not at all. A little discussed analytical question is: what is the lowest number of prostate cells that the PSMAPET can detect? If it could detect a single cell, the result might give you confidence regarding mets. Now, I doubt if this has been tested, but I would guess the first positive test would require dozens to hundreds of cells at least, so a negative test does not rule out PCa mets. Likely, it can at best only say that we did not find anything, but if it is in your body, the cancer load is likely quite low. Only a positive test is helpful (so to speak).

All of us better be rooting for the success of the treatment that attaches a cancer killing agent to the PSMA protein.

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