Any other methods Better than PSA to monitor prostate cancer?

A pet scan is good but expensive and insurance is slow to approve it

Agree with hbp, Pet scan or what they call PSMA is a very specific test to determine the presence of cancer cells.

Medicare did cover mine. I also had a Decipher and bone scan. The Decipher is also expensive but is a genetic test on the biopsies taken to determine the risk of metastasizing outside of prostrate and give as low, intermediate or high.

Not sure if this helps seasuite. But right now the PSA test are still the gold standard or prostrate irritation levels and cancer. Just a not PSA levels can rise and not be an indicator of cancer.

If it funny at Mayo Clinic about 10 years ago they were dismissing the need to do PSA test on older men. Then it came back. What my PCP said was, "they saw increase in latter stage prostrate cancer diagnosis and started PSA testing recommendation again."

But then I read some treatment provides don't recommend testing for PSA after age 70. I was diagnosed with prostrate cancer when I was 75 as a result of PSA rising numbers, MRI, then biopsies. I think the PSA testing kept mine from moving from low risk (Decipher test differed from biopsy) to intermediate or higher risk of metastasizing. But every one is different and what I think was best for me may not be best for others.

I do not believe PSA is well understood by the health industry in terms of what it means for PC...It apparently rises with age naturally. Many unnecessary biopsies happen a a result as well as follow ons,.

Thanks for all the helpful replies!! I had a PSMA PET scan, thankfully negative, and a Decipher Grid, 0.57 intermediate risk, run prior to beginning treatments. I asked my RO yesterday if another PET scan would be helpful, post treatment, and she did not believe it would be. At minimum, your comments are helping me think that I'm not missing anything and can stop looking. Regarding insurance, I started Medicare/Medigap G recently as I worked until 71 and had a company plan. It has been covering well and allows a lot of flexibility.

Unlike with RP, when you have a writhing organ to dissect postoperatively, radiation patients typically lie on a table with 'tv sets' revolving around us and we are to believe it's working. I am indeed a man of faith, but, also believe in verification.

Best to all!

You’re too forgiving. Stopping psa tests on me allowed it to rise silently to 985 and the cancer to metastasize to my bones. Incurable. Glad I’m in my 9th decade that something else will probably take me down first.

Seasuite: it sounds as if you skipped the Urologist as your family doctor was comfortable with making the diagnosis themselves.
Was your confirming MRI at the same facility?
I too tracked my PSA level for about 10 years and saw the rise that eventually made it to 10.2. Just like JC 76, I had the decipher test. Biopsy material, from what I understand, is good for about a year.
To me, it was always about Backup opinions. Doctors are dedicated, but not infallible. The decipher test was just another back up for me. It is also used by doctors for evaluation. Correct me if I’m wrong, JC 76, but I believe the decipher test helped you avoid additional treatments? For me, it was easy enough to read, and gave me some guidance as a layman.
In terms of PSA, my brother had a PSA at its peak of 6.5 even though his prostate cancer had invaded outside his prostate. He also ended up on Lupron and is not happy about its side effects. My PSA was 10.2 and did not invade outside of the Prostate. Everybody is different. My RO told me if my PSA rises by two points, then it is an issue. My last test a month or so ago was at 1.4 and I had my narrow margin linac treatment finished in February. I did not have any hormone treatment.

I'm not sure why my PSA scores didn't post correctly, but. I tried again with a .pdf since the .png was not working out. My PSA was always less than 5 and normal for my age.

I started with a urologist, then saw a different one when looking for a TPUS, rather than TRUS. The second urologist said that, for my specific cancer, he would personally get radiation, rather than surgery. I consulted a third urologist, who is one of the best known in the country and, while he advocated surgery, his final recommendation was neutral for my case. I also had a friend connection to a retired urologist, who is CMO for a medical foundation, and he provided candid advise independent of any of the institutions that I was dealing with, one of which he worked for for 16 years.

At the end of the day, each PCa is as different as a fingerprint. I would not advocate any treatment protocol for others, however, I like sharing my experience and hearing from others about theirs. Mayo connect is a great community for PCa sharing that is a primary 'support' group for me these days.

My family doctor did not make any diagnosis about my cancer. We spoke, at length, about her father's G9 PCa that was treated in Rochester. Her family is from MN, but, now she and I are in California. I was planning to consult at Mayo and, unfortunately, Dr. Gettman, who helped her father, is off to Dubai where he runs the clinic there. Also, due to legal restrictions, I could not complete a video visit unless I traveled to Rochester.

I think that many of these doctors are guessing as most even at Mayo would not give me a definitive answer. I have an excess spread sheet with every blood test going back to 2008 including my PSA. I have been varying between 2.3 and 2.9 for the last six years and no one would even give me a guess on how long I have had PC. The surgeon wanted to cut it out, the radiation oncologist wanted 28 treatments and six-month ADT till I told him I was looking at the 5 treatment CyberKnife, then all of a sudden "we can do five". I think these doctors just do what they are familiar with. I have also read articles that have said since they are so busy treating patients, they do not have time to actually keep up with the latest research in prostate cancer. See if you can get Urology Times sent to your email every day like I do.

bens1, Regarding having a Decipher test. Yes you are correct. I was original diagnosed with intermediate risk of metastasizing prostrate cancer based on biopsies. Hormone treatments were recommended based on that diagnosis.

I had the Decipher test after the biopsies (using the biopsies) and it came back low risk. The Mayo Oncologist/Radiologist notified me that based on Decipher test results the recommendation for hormone treatments was no longer recommended just radiation.

Mayo has a facility here in Phoenix if you are in California with a hotel right next door.