PSMA PET CT AGAIN!? Not good news!

[Alinur]

After my Cyberknife on 2 lesions in may 2018 and my PSA was as low as <0.003 three months ago.Today I got my PSa at 0.006.A MRI done 2 weeks ago showed some activity in spina iliaca whereI had the radiation 6 months ago but doctors could not say if it is recurrence!! more PSMAPETCTs ,more money to "loose". TA always adviced systemic therapy is a must to manage metastasis, he is right.but how long it will work!!

My question is if the same radiated area could be radiated again with the same Cyberknife radiosurgery? Any experience? Anyhow I have to do one more 18F PSMA pet CT....

Thank you all

[Tall_Allen]

0.006 is well within the range of extraprostatic sources of PSA.

How do you know there was increased activity? Did the size of the iliac lesion increase?

An 18F PSMA PET will probably tell you nothing new with PSA so low.

[Alinur in reply to Tall_Allen]

Thanks TA. The size has not increased.I have done the MRI just to see how the lesion looks like 6 months after Cyberknife. Here is what the radiologist wrote, quote"..presence of some infracentimeter focal zones with nonhomogeneous gadolinium uptake suggesting possible secondary determination".My oncologist saw it as inflammation from the radiation and dismissed the idea of recurrence. But

then I saw my PSA went from <0.003 in August to 0.006 today. I am not on ADT for 4 months. This is what made me think of another PSMAPETCT.

[tango65 in reply to Alinur]

Your PSA will have to be around 0.2 to get another PSMA PET/CT. I believe nobody will do a PSMA PET/CT with a PSA of 0.006.

[petercraig2]

I too was concerned about bone mets after a PET showed activity in left Ilium but was apparently related to excessive running and not PC.

However there is a blood test for serum alkaline phosphate which will usually increase in response to bone mets. So got a request approved from my Dr. and now have a baseline value for future reference should anything change wrt possible bone mets.

Normal Values

The normal value for alkaline phosphatase is 53 to 128 U/L for a 20- to 50-year-old man and 42 to 98 U/L for a 20- to 50-year-old woman.

Normal values are slightly different if you are older than 60 -- 56 to 119 U/L if you're a man or 53 to 141 U/L if you're a woman.

Normal values can vary slightly among testing laboratories. Normal values from the laboratory performing the test should be used when interpreting the test results.

Good luck

Peter

[Alinur in reply to petercraig2]

Thanks Peter,

My ALP is 41,even less than my usual 60-70 before. I had MRI not PETCT ... which showed the activity. My slightly rising PSA is what worries me .