1. < Prostate Cancer
Profile picture for thepilotusa

PSA levels started to rise again but negative PSMA PET

Posted by thepilotusa @thepilotusa, Mar 21, 2025

After radical prostatectomy my PSA levels started to rise. At PSA 0.5 I had a PSMA PET CT which showed no radiotacer-avid disease. At PSA 1.12 I had another PSMA image and, again, showed no radiotacer-avid disease. Has anyone gone thru this experience? Why my PSA levels continue to rise but nothing shows on the images? Lab used F-18 agent.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for mlabus3
mlabus3 | @mlabus3 | Jan 27 10:56am

1.) ED restoration, imo, seems to be low odds based on a lot of my reading and research. I am only 7 months in, but use Cialis and the pump with marginal results. However, Trimix is like a wonder drug for me. Its not for the faint of heart and takes all spontaneity out of sex, but, man, it works (for me)!

2.) Using PSMA to identify the location of your spread seems to be the hot topic. Eugene Kwon at Mayo is all over it and has several pretty compelling youtube videos. For example, https://www.youtube.com/watch. Kwon says that Choline 11 Pet scans can identify cancer at 2.0 PSA. His "combat manual" is also required reading if you want to get a good education.

Like most things related to prostate cancer, it can be confusing. As always, engage your treatment team to decide your course of therapy.

REPLY
1 reply
Profile picture for jeff Marchi
jeff Marchi | @jeffmarc | Jan 27 12:11pm
In reply to @mlabus3 "1.) ED restoration, imo, seems to be low odds based on a lot of my reading..." + (show)
Profile picture for mlabus3 @mlabus3

1.) ED restoration, imo, seems to be low odds based on a lot of my reading and research. I am only 7 months in, but use Cialis and the pump with marginal results. However, Trimix is like a wonder drug for me. Its not for the faint of heart and takes all spontaneity out of sex, but, man, it works (for me)!

2.) Using PSMA to identify the location of your spread seems to be the hot topic. Eugene Kwon at Mayo is all over it and has several pretty compelling youtube videos. For example, https://www.youtube.com/watch. Kwon says that Choline 11 Pet scans can identify cancer at 2.0 PSA. His "combat manual" is also required reading if you want to get a good education.

Like most things related to prostate cancer, it can be confusing. As always, engage your treatment team to decide your course of therapy.

Jump to this post

@mlabus3
Not so impressed by the choline PET scan. Other places must not be impressed either since Mayo is the only place that uses it.

Notice this image shows all the different types of scans, but the PSMA PET scan shows metastasis totally missed by the choline

REPLY
Profile picture for mlabus3
mlabus3 | @mlabus3 | Jan 27 1:23pm

You are correct. PSMA, from what i understand, is much more common. i used choline to demonstrate it could show cancer at .2 PSA. Mayo/Kwon talks to 4 different kinds of PET scans, in 2 different categories. (His presentation is as bit dated, so not surprising there are more at this point.) Hard to keep it all straight! Thats why I always caveat my comments.....

Thanks for the comment/correction!

REPLY
View MoreView Less
Please sign in or register to post a reply.