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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5 years sane as you Had L2 radiated 1 inch out PSA 1.2 for 2 yrs Now 4 5 6 so just had PET scan and Ct scan Results this week metastatic sensitive but may be going resistive to Zolodex

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I thought the same way (wait until it hits .4 then easier to locate and directly treat. My Oncologist at Johns Hopkins in Bethesda Maryland caution me against that stating along the line of ... Yes, easier to find, but harder to cure. Treated asap, that was this past Spring. Best wishes to you!

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Mayo Clinic Scottsdale. Im getting one on Dec 22

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@natem

I received a .2 psa, 8 years post RP. My psa went to .3 a few weeks later and had the PSMA scan. They think they found it and radiated the area. The Radiologist said it was non-conclusive, but I think they believe that was it in the lymph mode. Unfortunately not where I was hoping, but hopefully they got it early, or they didn't really find it, but treated the entire area anyhow. My concern is micro-metastasizing. I went the 37 radiation treatments and have about 1 month to go on Orgovyx, 6 month total.

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Hi ,I had robotic RP almost 4 years ago,PSA now up to 0.24 ,Had pet/psma scan and something noted in 1 lymph node but not conclusive. local public health hospital oncologist recommends 25 X radiotherapy with ADT, private clinic recommend regular surveillance with PSA testing and if continues to climb when reaches about 0.4 to do another pet/Psma scan then treat with proton therapy. I am nervous and undecided,have you had many secondary effects from the radiotherapy and hormone treatment.

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See my comments below. Am getting ready for 3rd PSMA PET scan. First 2 revealed IV Contrast uptake in lower right ribs, particularly 7 and 9. Scan directed by Urologist. Then saw Oncologist and they said not enough data was available on the cd to evaluate the extent of metastasized cancer. He ordered a CT with contrast IV of the chest and abdomen. The chest CT showed where and extent of metastasized cancer. In both CT's there were no other spots of metastasized cancer. The PSMA PET scan is an excellent tool to indemnity hot spots.

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I am getting ready for my 3rd PSMA PET scan. First two showed that recurred PC had metastasized on ribs 7 and 9 lower right side. Also had biopsy with negative results. Started taking Casodex 17 Nov. Psa taken 9 Nov 20.8. Psa taken 16 Nov 18.5. Lupron injection to be scheduled. 3 December had CT with contrast of both Chest and
Abdomen. CT's showed cancer metastasized in lower right ribs area and no other places. New Oncologist is replacing Casodex with Apalutamide. Lupron injection to be scheduled early January. Initially Oncologist said that I would take Casodex for 30 days with 6 month Lupton injection. New Oncologist is saying that I will be on Apalutamide the entire 6 month period with Lupron. The side effect list for Apalutamide scared the hell out of me, as I am also the caregiver for my other half. I am scheduled to have another psa taken 13 December. Have any of you taken Apalutamide and what were your reactions to the drug? My other half has early stages of dementia.

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@jondoetx

I was diagnosed with PC in Dec 2021. Gleason 9. PSA with Avodart 6.37. Stage T1a. Cancer invaded seminal vesicles. Had RP March 2022. Margins clean. PSA <0.05 (lowest blood lab can go), so determined undetectable. Have had 3 PSA tests since surgery and all <0.05. Did Pelvic CT and bone scan. All clear. Doing 39 rounds radiation now. Decipher score high. Asked Doc for PSMA. He said not needed. PSA test is better and bone scan clear. Should I go the extra mile and get PSMA pet scan? Redundant? Even if insurance won't pay, worth it? I want to be as sure as I can.

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I think the better question might be: should you go on ADT, not run a PSMA PET. With seminal vesicle invasion, I suspect the answer is yes.

I agree with the doc. His question on PSMA PET revolves around: would that alter the treatment? I think the answer is "no". I suspect you are receiving optimal treatment now. Once outside the prostate "bed", the places the PCa would go might not be amenable to localized treatment.

Consider this. My PSMA was clear. Does that mean I do NOT have mets somewhere? Not at all. A little discussed analytical question is: what is the lowest number of prostate cells that the PSMAPET can detect? If it could detect a single cell, the result might give you confidence regarding mets. Now, I doubt if this has been tested, but I would guess the first positive test would require dozens to hundreds of cells at least, so a negative test does not rule out PCa mets. Likely, it can at best only say that we did not find anything, but if it is in your body, the cancer load is likely quite low. Only a positive test is helpful (so to speak).

All of us better be rooting for the success of the treatment that attaches a cancer killing agent to the PSMA protein.

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@jondoetx

I was diagnosed with PC in Dec 2021. Gleason 9. PSA with Avodart 6.37. Stage T1a. Cancer invaded seminal vesicles. Had RP March 2022. Margins clean. PSA <0.05 (lowest blood lab can go), so determined undetectable. Have had 3 PSA tests since surgery and all <0.05. Did Pelvic CT and bone scan. All clear. Doing 39 rounds radiation now. Decipher score high. Asked Doc for PSMA. He said not needed. PSA test is better and bone scan clear. Should I go the extra mile and get PSMA pet scan? Redundant? Even if insurance won't pay, worth it? I want to be as sure as I can.

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Similar circumstances I would wait on pet scan when and if PSA rises

39 rounds 2018 on zolodex but took me off 2 years

4 years later castrate sensitive metastatic in L2 and T12 Had radiation Stage 4 no cure but can control they say

I has L2 lumbar nuked 1 inch pc out On Zolodex to stop testosterone the fertilizer of pc

Covid shots can throw off PSA tests Wait 3 months

My PSA 1.2 for years then 4 5 6 Just had bone and ct scans Results Monday 12th

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@jondoetx

I was diagnosed with PC in Dec 2021. Gleason 9. PSA with Avodart 6.37. Stage T1a. Cancer invaded seminal vesicles. Had RP March 2022. Margins clean. PSA <0.05 (lowest blood lab can go), so determined undetectable. Have had 3 PSA tests since surgery and all <0.05. Did Pelvic CT and bone scan. All clear. Doing 39 rounds radiation now. Decipher score high. Asked Doc for PSMA. He said not needed. PSA test is better and bone scan clear. Should I go the extra mile and get PSMA pet scan? Redundant? Even if insurance won't pay, worth it? I want to be as sure as I can.

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Correction, stage pT3b.

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I was diagnosed with PC in Dec 2021. Gleason 9. PSA with Avodart 6.37. Stage T1a. Cancer invaded seminal vesicles. Had RP March 2022. Margins clean. PSA <0.05 (lowest blood lab can go), so determined undetectable. Have had 3 PSA tests since surgery and all <0.05. Did Pelvic CT and bone scan. All clear. Doing 39 rounds radiation now. Decipher score high. Asked Doc for PSMA. He said not needed. PSA test is better and bone scan clear. Should I go the extra mile and get PSMA pet scan? Redundant? Even if insurance won't pay, worth it? I want to be as sure as I can.

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