Timeframe from PET scan to start of cancer treatment?

Mwarsha: like your husband, I, too, had Gleason 3+4. My PSA was 10.2 I had the MRI then a biopsy. I spoke with five radiation oncologists from 4 centers of excellence. Mayo has a great reputation and there are plenty of stories on this website about their success with prostate removal and Proton Therapy.

My research brought me down to either Proton Therapy (from Mevian) or the Mridian radiation machine from Viewray. I chose the Mridian. Unlike all other forms of radiation machines, including Proton, the Mridian has 2 mm margins versus 4 to 6 mm for all other types of radiation machines. That made a difference to me as my goal was to protect healthy tissue to encourage quality of life. The margins are how far out they radiate from the Prostate area. It is also the only machine that has a built-in MRI so everything is in real time and there is no fusion of imagery. I was encouraged to, and chose spaceoar gel to separate the rectum from the prostate by 1/2 inch. I found out about my cancer last October and started my radiation treatments in January. I had my five treatments finished in February of this year. The decipher test is helpful to test for aggressiveness and doctors use it for diagnosis. There is no doctor that can guarantee how quickly something will grow inside your husbands body and that concept pushed me into getting treatment as quickly as possible.

It is great that your husband has someone like you for support. Both of you might want to take one day at a time. It’s a process.

Thank you so much for all of this information.

I have not heard of the Mridian radiation. Is that something that is available at Mayo yet? I know they have the Proton radiation. Or is that only available at a different COE? That would be nice to look into. I know he would like to stay with Mayo (if possible) since it is reasonably close to us and we still have two kids at home, so extended travel would be difficult.

Thank you again, and I hope you are doing well since your treatment.

Mwarsha: I am not sure where you are located but here is a link to the viewRay website that gives locations of the machines in the United States.

Where I ended up being treated in Orlando, they had both the proton machine and the Mridian viewray linac radiation machine.

Many doctors will say that the outcomes for different machines are basically the same with some differences in the toxicity levels. It is difficult to get a doctor to talk about the subtleties of each individual machine and the side effects/quality of life issues in detail that you may experience from one machine to another. Obviously you can’t always predict everything But as I said before I made my decision based on what I thought would have the greatest chance of protecting my healthy tissue. To me that included multiple factors that the Mridian machine had that others did not. Feel free to contact me with any additional questions.

Thank you so much! I really appreciate this insight and information. Definitely agree that the less harm the better. My husband is only 52 and (other than this) is in great health, so we have a lot of incentive to keep him that way. We are currently hoping to be able to stick with Mayo, Rochester, so I will take a look at what you sent and see if they offer this.

Thank you again!!

Thanks for sharing your situation and asking for input. I would be curious to learn what sequence of events led to the biopsy, such as the PSA history. That being said/asked, it is perfectly normal to have unsettling feelings about the idea that cancer is in your body, however time is definitely on your side to make an informed decision. Self-education will be an important part of making that informed decision and it can feel overwhelming at first, but when you start asking questions based on your knowledge, you will feel that much better about how to interpret the answers from the professionals. Take a look at this article about life expectancy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923265/ to get a sense of where your husband fits into the curve of 50-59 years old, it all relates to his PSA at initial diagnosis.

Published studies from centers of excellence and clinical/trial studies that often times are rooted in new treatment methods will provide you with the largest sample size of information, however the forums will provide you a human-element and individual experiences. You will be able to find contradicting/inconsistent individual experiences, that is just a normal aspect of life, so value the input but also balance it with your knowledge base and also your personal feelings (which are the most important) in terms of how you deal with risk, uncertainty, how you define quality of life, and other factors.

be calm and stay strong, you have many options ahead.

Thank you for your reassuring words and the article. I wish he was as easy to reassure as I am … he’s a bit more challenging no matter how much information I give him due to the quick cancer death of his mom 😢.

For a little history, his first psa test was in 8/22 at 7.5, then they did the mri which they said came back clean. They suggested a biopsy at that time and he declined (convinced himself he had to be okay if nothing showed up on mri 😐). Next psa was in 2/23 at 8.7, next psa test in 5/23 was 10.3. At that time they did a 4k test and it came back at 80. Biopsy was then scheduled and here we are now 😞.

Thank you for sharing and I can empathize with his situation. My mother lost her father (my grandpa) to prostate cancer 40 years ago. From 1st diagnosis to death was 7 months, but that isn't how things work today!

With a PSMA PET coming up, I would encourage self-education to learn about the test itself and the types of tracers, this is a good place to start https://www.webmd.com/prostate-cancer/prostate-cancer-psma-detect and a key takeaway is that not all PCa responds to PSMA PET. In that article they will refer to sugar tracers, but them do a google search on a very similar test Choline-11 PET scan. At this point you will be much more informed about three tracers that are used for this test, the rationale selected by your health team.

I will take a look at this article as we travel tomorrow. We are heading to our daughters wedding… talk about timing … she doesn’t know and we won’t tell her until after she returns from her honeymoon.

Thank you so much for the links and the info. I didn’t realize there were alternatives to the PSMA. I don’t think his doctor gave any thought to best technology… just most convenient. 😐. We will be relieved to have the Mayo transfer complete and be in better hands!!

Thank you again ❤️❤️

Had ADT treatment start within one week of PET scan. Gleason 9 metastasized. EliGuard shot every 3mos. plus Aberatrone,1000mg. every day. 6 mos. now and blood work is good. PSA is .2. Age 83. For people writing in, you need to include your age and and how long you have been treated if started. I`m guessing, but someone 50 or 60 would be a lot more concerned about `walking around with cancer`. Don`t let the fear card make your decision, remember COVID. After following Holistic medicine for years, I believe most of have had cancer in our bodies for years controlled by our immune system until it is not. Best Wishes.

I was diagnosed on April Fools 2018. (Surprise!) I was only 58. My gleason scores were through the roof! 9's and 10's for every sample. As you can see I have been around for 5+ years.

I have to confess, when first diagnosed everything seemed to be moving too slowly. They did start ADT (Lupron shots) immediately, but my much needed prostatectomy wasn't until June 19 of that year. My advice would be trust your doctors. Everyone's situation is different and they are the experts on how to handle those situations. What I began to realize is that, unlike many diseases, cancer is slow growing, deliberate, and evil.

My last piece of advice would be stay positive. Laugh and play like you always have. I did. Make it challenge to kick the cancers ass. Enjoy the hell out of your daughters wedding. Live life.