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Looking for information on rib biopsy for prostate cancer
I had an RP 2.5 years ago. My PSA has started to rise and went to .15. While I was Gleason 3 4 there was EPE, two locations which margins could not be determined, cribform, 3a, and when the decipher test was recently taken it was .92. They recommended radiation and took a psma pet scan. It showed low avidity on the ribs. I was put on adt and a second pet scan was done and the advisory on the one questionable spot went down slightly so they cold not rule it out as cancer. Now they are looking to wait three months to try another psma/pet scan. It was suggested I could get a biopsy of the rib which may show cancer but if it does not than it does not rule out cancer and I would have to go back to the psma test. An mri was ruled out because it is small and the mri will have trouble picking up layers because it moves as you breathe. I need help with other people’s experience. I am on adt but like to get off of it.
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Something you’ll need to discuss with your medical team —> While you’re on ADT and your PSA is being suppressed, a PSMA PET won’t likely see much. (At a PSA of 0.15 a PSMA PET scan will miss prostate cancers more than 2/3 of the time - which is probably why, as you put it - “the one questionable spot went down slightly.” With your cancer (& PSA) being suppressed due to the ADT, the PSMA PET scan simply wasn’t sensitive enough to see it.)
If you wait three months to try another psma/pet scan, will you still be on ADT during that time?
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1 ReactionA crack in a rib from years earlier can be suspected of an issue, but can mean nothing. I had that report from a rib that broke 50+ years ago.
Bone biopsies are difficult to do but it may eliminate it as an issue.
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3 ReactionsThanks Jeff, at this point I just want to establish where I am headed.
While you are waiting to get a new PSMA PET scan, you could also use the Episwitch PSE blood test here http://www.94percent.com to see whether you have a recurrence of prostate cancer or not.
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3 Reactions@brianjarvis
The first psma pet scan showed three spots on the ribs with low avidity. They then put me on adt and if the advidity came out the same it would be considered non cancerous, if the avidity disappeared because of the adt then it is cancerous
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1 Reaction@wwsmith Both of my consultations agree I have a reoccurrence and recommend radiation. With the high decipher reading, two locations with no margins and the 2.5 cm size they both agree the prostate bed needs to be irradiated. The only question now is did it get outside the prostate bed. The ribs are a common area where they get false positives on the psma pet scan test.
The Episwitch is used to determine whether you have cancer when you have a prostate. If you have a high PSA it can give you a better idea if you have cancer and a biopsy of the prostate should be done.
@pamperme
Actually, the PSE test remains accurate even after your prostate has been completely removed because it does not rely on prostate tissue being present. It measures immune cell confirmation signatures in the blood, which reflect whether your immune system has been interacting with prostate cancer cells anywhere in the body. It’s a biomarker test that works to detect prostate cancer before treatment and after any treatment.
If a rib biopsy does not show cancer, why doesn’t that rule out cancer? At least in the rib, anyway. That’s what a biopsy is for, right?
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2 ReactionsMy understanding is they can only get a small sample and do not always pick up the cancer. I wish it would rule it out so could get on with the radiation if it is negative. To wait three months for another psma pet scan keeps me on the adt longer. Also what happens if it is not definitive again. Thanks Phil
Hopefully if it comes out negative it will help with the next decision on the psma