Metastasis Test.

[Burnett1948]

burnett1948. I am seeing my Urologist next week. What is the best test to ask to find out if my recurrent Pca has metastasised?

[Hidden]

Have you checked your PSA recently? If so, what is the current level?

[Burnett1948 in reply to Hidden]

Burnett1948. gregg57 my August 2018 PSA is 4.1 up 2.5 in February 2018.

[YostConner]

By "recurrent" do you mean you still have your prostate (maybe following radiation)? there are more particularized tests available, bu the initial tests are usually a bone scan and CT scan.

[Hidden in reply to YostConner]

I agree, unless his PSA is under 10. In that case they probably won't see anything with a bone scan and CT. He would probably be looking at something more sensitive like one of the latest PET scans.

[Burnett1948 in reply to YostConner]

Burnett1948.YostConner I had a RP in 2005 but with 6mm missed. I had salvagage radiation 2009. My last PSA was 1.5 inFeb 2017; my doubling is 18 mths. I have had 2 Bone scan a way back and a PET scan about 18 mths ago. All clear. I am sure I have read PET scans aren't that reliable. I have also read that a fellow member's Pca had metastasised when his PSA was about my score. My journey was almost the same as his. I have just had a PSA blood test ready for next week's appointment

[Hidden in reply to Burnett1948]

Whenever I consider tests, I always ask my doctor the question: how will this effect my treatment plan? My 2 medical oncologists are in full agreement with this approach. From your previous posts, it sounds like you have a good treatment plan already: starting ADT when your PSA reaches 8. The question I would be asking is how will the tests effect/change that? It may be a while before you can see exactly where the "mets" are.

You may also want to consider adding upfront chemo or Zytiga based on the results of the CHAARTED, STAMPEDE, and LATITUDE trials.

Good luck with your appointment and let us know how things go.

[Burnett1948 in reply to Hidden]

Burnett1948.Thanks Gregg57.

[Hidden in reply to Burnett1948]

With your last PSA of 1.5 and doubling time of 18 months, there is one more thing I would recommend. Go out and do a happy dance!

[Burnett1948 in reply to Hidden]

Burnett1948. Gregg57 you have just put a smile on my face. I was told in 2012 it would be a lot different. That prediction is still with me. Also I read that PSA's can be unreliable. I am a conservative type.

[Hidden in reply to Burnett1948]

I'm probably not the only one here who would love to have a PSA doubling time of 18 months. My PSA graph looked more like a rocket launch.

[Burnett1948 in reply to YostConner]

Burnett1948.YostConner. I have had those test. I had Robotic RP in 2005 when 6 mm was left behind and I wasn't told. When my PSA got to .4 in 2009 I has salvage radiation. A new Urulogist told me in 2012 that the 6 mm was missed. I was told in 2015 because my PSA rise was slow if I had Hormone treatment I would get another 10 years by the Urologist who missed the 6 mm. I guess he missed the 6 mm at one end because he told after the operation my prostate was large. I understand these days it would be shrunk by hormone treatment.

[Daddysdaughter]

C11-choline PET scan at Mayo Clinic

[Burnett1948]

Burnett1948. Thanks Daddysdaughter.

[BigM62]

I am recently diagnosed with stage 4 with numerous mets to spine. My PSA 2 months prior was 2.9. Only scans can tell.

[ronronHU1]

Hi Burnett1948, If you have recurrence 'post RP'...not sure what procedure you have gone through (most doctors agree that recurrence is present at PSA levels >0.2); however, I am relatively sure that the 68Ga-PSMA-PET/CT and the F-18 scans are the most sensitive currently available. I have spent a great deal of time on this subject and believe that the Choline-C-11 PET scan at Mayo Clinic requires a minimum PSA of 1.7 to pick up metastasis whereas the 68gallium and the F-18 are able to identify involvement at PSA levels >0.7. I just had the 68Ga scan done at Peter McCallum Cancer Center in Melbourne, AU and it identified three sacral LNs with a PSA of 1.0. I just had them resected robotically at UCI. Only time will tell if the surgery was effective. My best to you, Ron

[Sisira]

IMO you have two options ( Both offered by gregg57 ). I only ask you to look at them objectively with the long term benefits in mind. You qualify for both.

- Early chemo - hormonal treatment ( supported by STAMPEDE, CHAArTED and LATITUDE )

- Go out and do a happy dance ( PSA doubling is 18 months ) - There is no guarantee how long you can dance!

Wish you the best

Sisira

[eggraj8]

CT Scan and Bone Scan.

[Break60]

Your psadt is good news . Mine was a month. When my PSA reached 2.0 I had the axumin ctpet which found a bone met. It's available widely now.

Bob

[Howard53545]

Get another scan and locate the PC then microwave it.