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Has anyone had the PSMA-PET scan? Was cancer found?

Posted by hector13 @hector13, May 12, 2022

My prostate was removed 5 years ago. Two months ago, my PSA went from 0.00 to 0.09, and this month the PSA increased to 0.2. My urologist believes I am a candidate for the new PSMA-PET scan approved in 2020 that is more sensitive than previous scans in detecting small tumors. Has anyone had this scan? If so, what was your PSA at the time and was the cancer found?

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woodworker | @woodworker | Dec 26, 2022
In reply to @scullrower "To continue, after the cancer was found to be isolated in the pelvis, I was treated..." + (show)
@scullrower

To continue, after the cancer was found to be isolated in the pelvis, I was treated with five rounds of SBRT. Three months later my PSA was undetectable. This is after 21 years since diagnosis, surgery, then first recurrence treated with radiation, second recurrence treated with Lupron, third recurrence scanned then radiation. Rule of thumb: get scanned, then treated. If you can see cancer, you know better how to treat it. Any recurrence should be seen as an opportunity to kill it. Get second opinions and seek curative treatment, if possible. Don’t settle for palliative treatment except as last resort. Finally, if you aren’t satisfied with your local doctors, got to a center of excellence. I had better communication with docs at UCLA than I did at home.

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Yes, Dr Kishan at UCLA was really great along with the staff, absolutly top notch. I was in a trial using the VewRay. PSMA was undectable at 0.25 PSA but the trial was using SBRT for this type of situation which was in the past used primarily for actual tumors.

Recap: My Gleason 4+3, cancer returned after prostatectomy then started 6 mo. ADT with Orgovix then UCLA ViewRay SBRT treatment. Now 5 months after SBRT PSA 0 still waiting for effects of Orgovix to wear off and have testosterone return, fingers crossed as my ride with ADT hasn't been very pleasent at all...

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1 reply
bettwils16 | @bettwils16 | Dec 26, 2022
In reply to @spryguy "I had a PSMA P/CT in Aug with a PSA of 1.2. It confirmed the PCa..." + (show)
@spryguy

I had a PSMA P/CT in Aug with a PSA of 1.2. It confirmed the PCa that was indicated in the previous biopsy in Feb 2022 and CT scan in Mar . Initial PSA was 80. After IMRT and Lupron it went to 1.2. I was very relieved by the PSMA P/CT results as the scan indicated no additional lesions. The scan can be a positive force even if it shows some lesions. These lesions can be attacked accurately and directly at there location.
I am now prescribed Zytiga for 2 years (initiated September 1) and we are optimistic that there will be a remission (or a cure??). PSA is now 0.1 and falling.
Good Luck with your scan.

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Hi, how did you do with the IMRT? Any side effects? My husband will be starting IMRT next month. Did you use SpaceOar gel? Any advise? Thanks

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1 reply
dsingstock | @dsingstock | Dec 17, 2022
In reply to @aldenrobert "Thanks for your reply and for sharing part of your PC journey. I had my second..." + (show)
@aldenrobert

Thanks for your reply and for sharing part of your PC journey.
I had my second PET/CT scan yesterday morning and got the results that afternoon. My oncologist reviewed the scan and noted on the test results "There is a moderately PET avid site near the right lung hilum that may be prostate cancer. Consideration for biopsy should be made." Everything else looked fine.
You said your first two PSMA PET scans showed a contrast uptake in your lower right rib area. Are those areas clear now? Did you have a biopsy on them or any treatment to them?
From what little I have read up on this it seems rare for prostate cancer to metastasize in the lung only. I have also read that once prostate cancer does metastasize in the lung it is very serious and deadly. When I have my next teleconference 12/30/22 with my Oncologist he wants to discus doing a biopsy of the site.
The only other time I had any sort of biopsy was when they biopsied my prostate. When they were doing that one of the biopsy needles went thru my prostate and into my bladder and took a sample of my bladder. When I got those results it showed that I had a high grade prostate and a separate low grade bladder cancer.
But in the mean time, I feel great. I am on no treatments and my bladder cancer is in remission without having any medical treatment for it.

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Thanks for getting back with me. PMSA PET scans 1 and 2 showed vontrast uptake in the lower righ ribs. CT of tye chest showed slight lexions on ribs 7 and 9. Since I had 25 sessions of radiation and Bracytherapy 12 years ago I still have my prostate. Dr did a recent biopsy of 12 samples all negative. Oncologist I itially put me on Casodex. New Oncologist changed to Apalutamide. Express Scrips did not carry the drug, so then they said Xandia. Now there is another hiccup with that drug that I will have to get worked out. Still have Lupron/Elegard injection scheduled for 9 January and OSMA PET scan scheduled for 4 January. Will let you know how the drug issue is resolved and results of the scan. Not looking for hormone therapy as Oncologist said it is a life long treatment. Take care and think positive. Glad you are feeling good.

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aldenrobert | @aldenrobert | Dec 17, 2022

Thanks for your reply and for sharing part of your PC journey.
I had my second PET/CT scan yesterday morning and got the results that afternoon. My oncologist reviewed the scan and noted on the test results "There is a moderately PET avid site near the right lung hilum that may be prostate cancer. Consideration for biopsy should be made." Everything else looked fine.
You said your first two PSMA PET scans showed a contrast uptake in your lower right rib area. Are those areas clear now? Did you have a biopsy on them or any treatment to them?
From what little I have read up on this it seems rare for prostate cancer to metastasize in the lung only. I have also read that once prostate cancer does metastasize in the lung it is very serious and deadly. When I have my next teleconference 12/30/22 with my Oncologist he wants to discus doing a biopsy of the site.
The only other time I had any sort of biopsy was when they biopsied my prostate. When they were doing that one of the biopsy needles went thru my prostate and into my bladder and took a sample of my bladder. When I got those results it showed that I had a high grade prostate and a separate low grade bladder cancer.
But in the mean time, I feel great. I am on no treatments and my bladder cancer is in remission without having any medical treatment for it.

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1 reply
dsingstock | @dsingstock | Dec 17, 2022
In reply to @aldenrobert "I had my first PSMA PET on 01/12/2022. My PSA was 1.29 at that time. My..." + (show)
@aldenrobert

I had my first PSMA PET on 01/12/2022. My PSA was 1.29 at that time. My lowest PSA was .37 post RRP (03/25/20210). PSA continued to rise, by 09/09/2021 it was up to .69. Then on 09/27/2021 I began 34 rounds of radiation to the pelvic bed. Post radiation PSA had risen to 1.29 so that is when I had my first PSMA PET. No metastasis were found.
My PSA has continued to rise with a doubling time of 4 months. On 11/11/2022 PSA was up to 6.56. Today I get my second PSMA PET scan.
I am 63 years old and have only been on this Prostate cancer journey for two years. So far the treatments I have had have not resulted in any cure. When I met my Urological Oncologist just after my 1st PSMA PET, he said that based on everything he was reading in my medical record he would expect me to have multiple metastasis. He told me that any further treatments were all non-curative and all had major side effects.
The expectation is this scan will show metastasis and I will move from stage 3 advanced Prostate Cancer to stage 4. I will know soon enough.

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Heading for my 3rd PSMA PET scan 4 January. That is what the Urologist wants. The Oncologist wanted 2 CT scans with contrast IV. Had those and PC showed up metastasized on ribs 7 and 9. The Oncologist has me on Xtandi with first Elegard injection on 9 January. So far feel great. Both Urologist and Oncologist have scheduled psa and evals the end of January. Both the chest and abdomen CT'S showed no other metastasized areas. Oh, first two PSMA PET scans showed a contrast uptake in the lower right rib area.

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melcanada | @melcanada | Dec 17, 2022

Yes same path at 74 had radiation then on Zolodex for 2 years In 2021 had to have L2 radiated to take out 1 inch metastatic cancer Then 1 1/2 years bone scan shoed some areas in my T11 T12 and left hip So my stage 4 castrate sensitive is going castrate resistive In Jan after our Aruba cruise medical oncologist putting me on Enzalutamide 4 daily chemo pills Prognoses if hopefully 5 years or more I am 78 now

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aldenrobert | @aldenrobert | Dec 16, 2022

I had my first PSMA PET on 01/12/2022. My PSA was 1.29 at that time. My lowest PSA was .37 post RRP (03/25/20210). PSA continued to rise, by 09/09/2021 it was up to .69. Then on 09/27/2021 I began 34 rounds of radiation to the pelvic bed. Post radiation PSA had risen to 1.29 so that is when I had my first PSMA PET. No metastasis were found.
My PSA has continued to rise with a doubling time of 4 months. On 11/11/2022 PSA was up to 6.56. Today I get my second PSMA PET scan.
I am 63 years old and have only been on this Prostate cancer journey for two years. So far the treatments I have had have not resulted in any cure. When I met my Urological Oncologist just after my 1st PSMA PET, he said that based on everything he was reading in my medical record he would expect me to have multiple metastasis. He told me that any further treatments were all non-curative and all had major side effects.
The expectation is this scan will show metastasis and I will move from stage 3 advanced Prostate Cancer to stage 4. I will know soon enough.
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1 reply
bettwils16 | @bettwils16 | Dec 15, 2022
In reply to @hector13 "Hi Bandit11 - I am curious as to why your physician ordered a PSMA-PET scan after..." + (show)
@hector13

Hi Bandit11 - I am curious as to why your physician ordered a PSMA-PET scan after previous MRI and bone scan showed no cancer present?

To Everyone Else - After having prostate removed, radiation therapy and 4 years of 0.00 PSA, I have a PSA that has risen to 0.2. This is supposed to be the lowest figure that the new PSMA-PET scan can locate, but I wonder if this newly approved scan will find it at this level. Can anyone comment on whether they had this scan at around 0.2 , and what was the result? Was the cancer located? Hector13

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Hi, PSMA PET was done d/t psa .20, .24, .24; prostatectomy 8 yrs ago; psa didn't go up until 2023; Rad One suggested 8 weeks of radiation. Need to talk to him again. I'm thinking pelvis? What's your current status? Any treatment?

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bettwils16 | @bettwils16 | Dec 15, 2022
In reply to @wenv "Just to update my post. On Nov. 28th I had my second PSMA/PET scan at the..." + (show)
@wenv

Just to update my post.

On Nov. 28th I had my second PSMA/PET scan at the University of Washington. My PSA on 10/14/2022 was 1.40.

The short, cryptic text message from my oncologist was in part,

"The scan showed no evidence of disease".

He went on to add that he is recommending that I begin treatment of the pelvis region for 8 1/2 (eight and a half) weeks.

I'm waiting for an appointment and/or phone call to answer multiple questions.

Here''s some of the questions:
Why eight and a half weeks?
Is that radiation or ???
His message doesn't use the term "radiation".
Why isn't the PSMA scan finding the cancer location?

Hopefully I will be able to ask my Doctor the above questions.

Thanks in advance.

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Hi, I'm in the exact same boat. PSMA PET neg. What answers did you get? Waiting to hear from Radiation Oncologist. Biochemical recurrence, per psa, but where?

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durham362abcd | @durham362abcd | Dec 13, 2022

Yes two scans 7 months apart Showed increase in lymph node highlites near aorta Waiting and considering going back on androgen therapy

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