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Is PSMA PET scan used for staging?

Posted by newjersey2 @newjersey2, Jul 16 12:33pm

I was recently diagnosed with prostate cancer. The biopsy returned positives in 3 clusters (equal): grades group 1, 2 and 3. My urologist is calling it Grade Group 3 and he is asking me to do a PSMA test for staging. I read that this test can return false positives (beging items) and many more other cancers. Does anyone have any experience with this. I am currently looking to get sec opinion.

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lag | @lag | Jul 18 4:31pm
In reply to @jeffmarc "The PSMA pet test specifically tests for PSMA found in the body. There are a few..." + (show)
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The PSMA pet test specifically tests for PSMA found in the body. There are a few places where it is naturally produced, and that is known. If you’ve had broken ribs, they can show a SUV but it is minimal.

You are actually getting the ideal testing. I would definitely want to get a PSMA PET scan before treatment to make sure there is nothing else found in the body.

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@jeffmarc I sure didn't mean to mislead newjersey2 or spread inaccurate information on this forum. I was reacting based on my husband's experiences, some of which were many years ago. My husband first met Dr. Kwon at Mayo Rochester in October of 2010 and has been seeing him there regularly since January 2011. It has been a long time since then, and the standard of care and availability of scans have changed. My husband had his initial staging at Mayo using a C-11 choline PET scan and continued having them for many years after becoming a Mayo Rochester patient. They may have been the most sensitive scans for detecting recurrence of prostate cancer available then, and because Mayo Rochester produced the choline on site, it was readily available there. The PSMA PET became available more recently and is more sensitive than the C-11 choline PET in detecting recurrence, so my husband has had mostly PSMA PET scans in recent years. However, Dr. Kwon still orders a C-11 choline PET periodically in order to see if any active cancer has popped up which doesn't express PSMA and is therefore not detected on that scan. In my husband's case, the choline PET has sometimes found cancer which didn't show up on the PSMA PET, so having both scans available has been useful for us.

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Jeff Marchi | @jeffmarc | Jul 18 5:14pm
In reply to @lag "@jeffmarc I sure didn't mean to mislead newjersey2 or spread inaccurate information on this forum. I..." + (show)
Profile picture for lag @lag

@jeffmarc I sure didn't mean to mislead newjersey2 or spread inaccurate information on this forum. I was reacting based on my husband's experiences, some of which were many years ago. My husband first met Dr. Kwon at Mayo Rochester in October of 2010 and has been seeing him there regularly since January 2011. It has been a long time since then, and the standard of care and availability of scans have changed. My husband had his initial staging at Mayo using a C-11 choline PET scan and continued having them for many years after becoming a Mayo Rochester patient. They may have been the most sensitive scans for detecting recurrence of prostate cancer available then, and because Mayo Rochester produced the choline on site, it was readily available there. The PSMA PET became available more recently and is more sensitive than the C-11 choline PET in detecting recurrence, so my husband has had mostly PSMA PET scans in recent years. However, Dr. Kwon still orders a C-11 choline PET periodically in order to see if any active cancer has popped up which doesn't express PSMA and is therefore not detected on that scan. In my husband's case, the choline PET has sometimes found cancer which didn't show up on the PSMA PET, so having both scans available has been useful for us.

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@lag
Prostate cancer can become a neuroendocrine, In that case and in later stages, it does not produce any PSMA so the scan can’t see it. Usually, they will use an FDG scan to find neuroendocrine cancer, Since it consumes glucose, which is not used by regular prostate cancer.

The Choline PET scan cannot Detect neuroendocrine prostate cancer, So if that happens, neither of the scans Dr. Kwon is doing can detect it. That cancer is also very aggressive and people usually don’t live too long after getting it, so detecting it early is important.

I’ve seen side-by-side scans and the choline scan doesn’t really appear that easy to distinguish compared to a PSMA PET scan. I do know Kwon likes it.

Here’s a sample of various scans.
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swl1956 | @swl1956 | Jul 18 5:23pm

Get the PSMA PET scan for sure! It's an easy test that's very good at determining if Pca has spread.

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