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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@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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@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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@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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@bettwils16

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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I did 39 sessions 5 days per week. No side effects for first 3 weeks or so then tiredness and difficulty w urination for the balance of treatments and continuing. Flomax works for the pee issue but makes me dizzy on occasion. After treatment the tiredness became worse and the bowel issues began. No accidents but some quick walks to the loo. I requested a "Space Oar" pre IMRT but was told they didn't do that.
The results were very encouraging despite the lack of "excellence ".
The "no SpaceOar" and inattention to pre radiation test results caused us to apply to Mayo (2hr drive) where we discovered "excellence ".
The IMRT was pretty easy and turned into part of a daily routine.
Good luck . Questions? Ask away.

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@spryguy

I did 39 sessions 5 days per week. No side effects for first 3 weeks or so then tiredness and difficulty w urination for the balance of treatments and continuing. Flomax works for the pee issue but makes me dizzy on occasion. After treatment the tiredness became worse and the bowel issues began. No accidents but some quick walks to the loo. I requested a "Space Oar" pre IMRT but was told they didn't do that.
The results were very encouraging despite the lack of "excellence ".
The "no SpaceOar" and inattention to pre radiation test results caused us to apply to Mayo (2hr drive) where we discovered "excellence ".
The IMRT was pretty easy and turned into part of a daily routine.
Good luck . Questions? Ask away.

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Thank you! Did you go to Mayo after IMRT? I've been reading and reading because everything is so new to us. Hopefully, when we meet with Rad Onc, they'll agree to SpaceOar. We're you able to drive yourself? I'm thinking I need to take time off from work

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It took a while to get the Mayo appt.. It ended up being the Mon following the last Imrt treatment . I had no trouble driving down to Mayo Phoenix .
We did stay overnight (Mayo Residence Inn) in case traffic was bad. In October I drove down and back on the same day with no problem. I will
drive down again on Jan 30 for another blood test (10:30) and consult with Doc. or P.A. at 12:30 (blood test results are that fast). Home after that.
It really is like staring into a pitch black room and then you step in and become immediately lost. At least that's how we felt. We have all this modern medicine and no guide to answer questions or lead us to the part we require. I can say that eventually things settle in to a course of treatment that allows some hope and then a routine that is acceptable and accepted. Please ask any questions and we will reply to the extent possible.

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I have had two pet scans with f18 psma and have found a recurrance of pc in some lymph that would not have been seen on an mri or cat scan. All under 1 cm.. Hope that helps.
Phil C

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I am in a different situation as I am pre-treatment, but I have been diagnosed with intermediate prostate cancer which is still in debate, but most likely unfavorable due to a high risk score on a Decipher genomic test .. Having learned from a presentation from the PCRI about the benefit of using the PSMA Pet scan for more accurate grading, I requested a PSMA Pet scan... Honestly, I was worried the cancer may have metastasized and of course this would have guided me to the best treatment for me based on all of the testing... In my case, the PSMA Pet scan confirmed that the cancer was contained within the prostate.. I truly believe the PSMA PET scan should be a standard before any treatment is selected..

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To cerler and stinkeye,
There is now PSMA testing in AZ at Dignity Health Cancer Institute in Phoenix. It's been available since around Jul/Aug 2022. I had my scan early August of 2022.

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@cactus132

To cerler and stinkeye,
There is now PSMA testing in AZ at Dignity Health Cancer Institute in Phoenix. It's been available since around Jul/Aug 2022. I had my scan early August of 2022.

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My apologies for not being more specific. The scan I had at Dignity Health Cancer Institute was using GA-68 PSMA.

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