MRI Seems to indicate Prostate cancer recurrence

Your PSMA-PET scan is not going to show anything until your PSA post surgery reaches .2 and even at that level it only has a 30% chance of detecting any cancer cells.

Yep. We make the best decisions possible at the time with the data we have. Some of us will win this game. Others won’t. “Trust in the Lord with all your might, and lean not onto your own understanding. In all your ways, acknowledge Him, and he will direct your paths.”

I am only going to get one if after 3 months as it has been 1 now shows a bump up from 0 to .4 or higher. I did not know that 30% mark though. Thanks so much for that gkm. I am praying for a 0 reading as that will go a long way.

I don't like the fact that they make all these various test results available for the patient to see, before the ordering physician has a chance to review them. I know bits and pieces, enough to make myself look ignorant if I opined. Best wishes for you, hopefully your doctor's been in touch to review by now.

I disagree. I like to know the results so I can prepare for my visit. I suggest to those who do not to simply not look at them.

That's a choice, depending on your patient style, you can choose not to see them and wait until your consult for your medical team to explain them to you...or you can review them and formulate questions for your consult. I'm in the latter category and the medical team I have prefers that I come into our consults informed and ready to engage in discussion.

I just finished a message to my radiologist and oncologist with treatment decisions I wanted to discuss in our October consult along with data from the ARCHES , here it is:

At this point in my treatment plan, the clinical results are exactly what we wanted.

I do not enjoy treatment, the SEs, fatigue, muscle and joint stiffness, hot flashes, challenges with managing my weight..

The Orgovyx, combined with the SBRT are doing exactly what we had as an objective of my treatment plan, T is castrate at < 9, PSA is undetectable at < .04. I expect labs in October will show the same.

Since we are taking this treatment in three month intervals, making a decision at each point, I wonder about adding the ARI and the risk, benefits.

My objective is to gain the longest progression free period off treatment while balancing the risk-benefit of doing so since it may involve adding another drug to the treatment.

So, my questions for our October consult are:

Do we stop treatment at six months and actively monitor?
Do we continue Orgovyx to 12 months?
Do we add an ARI?

While I understand there is no assurance about differences in progression free survival , overall survival...between the three potential treatment decisions... the SEs of adding an ARI, your input as to that decision is key to any decision we make.

The ARCHES trial is intriguing as I think about that decision - https://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/144592-the-efficacy-of-enzalutamide-plus-androgen-deprivation-therapy-in-oligometastatic-hormone-sensitive-prostate-cancer-a-post-hoc-analysis-of-arches-beyond-the-abstract.html

As a patient reading various reports, it seems it may meet one of my objectives, a more durable progression free survival. I also realize that this trial combines ADT and an ARI while I have included SBRT so perhaps it is more or less equivalent.

It's a challenge for me to navigate the treatment world of prostate cancer treatment. I look forward to our discussion and decision in October based on your counsel and guidance.

Thanx

Kevin

Agree different patient style.

I wasn't limiting my remarks to PC. I just can't imagine getting a lung scan done as routine, then opening it up and see I'm riddled with cancer tumors, it's Saturday and I can't reach anyone until Monday at best. I agree with you, the patients who wants to see it and prepare certainly should be able to.
You sound nearly as qualified as your medical teams, so that makes more sense, but to each his own. As I recall, you've been through a lot and maintain a great attitude. believe you may keep a graph outlining your history, if so, that was very helpful. If I'm correct, you've helped me with some info, Thank you for that! More power to you! God bless and best wishes!

You're right, there's some medical tests that as a person who was not destined for a career in the medical field are best left to the experts to interpret and explain. My cardiologist had a hyper-coagulation study done on me. because of previous DVT and PE history and potential conflicts with PCa medications. I saw the results on my portal, all were in normal range. I looked up what each of the tests were done for and what out of range results might indicate, part of my preparation for discussions with my medical team, Both my cardiologist and oncologist messaged me to say "the results were" in normal range..." I got that, what I need to understand is what does that mean, do we still not know what caused my PE and DVT in 2010 resulting in being on blood thinners ever since, can I stop blood thinners s a result of these results...

Yeah, it's been a journey but our experiences help each other out, that's why we share1

Had a pet scan @2.3psa post surgery. Shows pea sized residual mass. Wanted another after 6mos adt. They say pet scan will show nothing after 5mos undetectable psa. They want mri.Eager to know if adt shrunk residual tumor