Why Us?

@jeffmarc I get the impression that the Mayo thinks it's an important test. Do you know why?

@lag Thanks so much for the detailed information! I wondered what the distinction was.

With one week to go before my surgery, I'm feeling surprisingly positive and at peace. A big part of that is because of the support, encouragement, and kindness I've received from all of you. Thank you. It truly means more than I can express.

Over the past few weeks, I've been trying a few things to help me stay calm and focused. My medical team sent me some resources on relaxation and mental preparation before surgery. One of the books they recommended was *Prepare for Surgery, Heal Faster* by Peggy Huddleston. I've found it helpful and reassuring.

I've also started drinking chamomile tea again. I bought a large bag months ago and hadn't used much of it. Now I'm making a big container with chamomile, honey, and ginger and sipping it throughout the day. I started yesterday and had one of the best nights of sleep I've had in quite a while.

Another thing that's helped me is listening to a YouTube recording based on Stoic principles. It's about four hours long and designed to be played while you're sleeping. Whether it was the tea, the book, the audio, or all of it together, I woke up feeling more rested and centered.

I know many of us here are dealing with our own health challenges, worries, and uncertainties. What helps one person may not help another, but I wanted to share a few things that have been helping me as I prepare for surgery. If even one of them brings someone else a little comfort, it will be worth sharing.

Here's the link:

@jime51

Yeah, I had Afib too...was it the ADT or just getting old?

Medications didn't control it and when my choices were medications that required a three night stay in the hospital when starting because of the risk of severe side effects, that was decision time for cardio ablation.

That brought a three year hiatus.

Had an episode three weeks ago, lasted about five hours, nothing since.

I let my medical team know, they said if it continues, ablation is still an option.

I tolerate Eliquis well, never had an issue with bleeding so it managed my stroke risks.

Life, aging, sigh...

@jime51
It could be because not everybody produces PSMA, And if they have neuroendocrine cancer, they don’t produce PSMA With it.

Other than those situations, I do not understand why choline scan would be better than a PSMA scan. Something I would I want to ask their doctors. There’s a meeting next week maybe the opportunity will appear at that time.

@kujhawk1978 My Afib was discovered before I started ADT. Eliquis has really cramped my style for arthritis pain medication and blood/platelet donations. I have arthritis virtually everywhere my bones have joints and places between, but I'm stubborn enough to keep going. It would be nice to have access to NSAIDs and to continue my 30 years of blood donations. Maybe by next summer....

@jeffmarc The C-11 choline PET scan was said at the time it was introduced to be the most sensitive for detecting prostate cancer and other cancer recurrences. My friend who is in charge of imaging at a large academic medical center says that the PSMA PET scan now is more sensitive and therefore can detect prostate cancer recurrences earlier than the choline PET, but that only applies to recurrence cancer cells that express PSMA. The choline PET is still better at detecting cancer cells that don't express PSMA, as happened when my husband's choline PET found his oropharynx cancer that the PSMA PET couldn't "see." I would also add that after he finished Pluvicto, during which he had several PSMA PET scans, my husband had a choline PET to determine whether other types of cancer cells had become active while Pluvicto was drawing everyone's attention to those cells that expressed PSMA. That was the protocol at Mayo Rochester in 2024 for patients who had recently completed Pluvicto, and of course it was possible to add the choline PET because they made the choline in house.

Another, more cynical point is that because Mayo invested a lot of money and time into getting government approval for and into producing and using choline in Rochester, it had and still has a financial incentive to use choline PETs. My aforementioned friend in charge of medical imaging at a large academic medical center believes that the profit motive explains Mayo's continued use of choline.

@lag
Definitely got a laugh out of the profit motive point of view.

I wouldn’t be surprised if the FDG or AXUMIN scans could do the same thing as The choline is used for.

You explanation was really interesting. It’s good to hear that you had a real beneficial result of taking the choline pet scan.

@jeffmarc I don't get the impression that it's better than but rather "other than." Mayo may do both, depending on biopsy results. I hope the answer appears!

For me I think it was my exposure to chemicals and burn pits after being drafted