Hello my dad was diagnosed in 2014 with Mets to bones and Gleason 9 he has been on Lupron every three months and xgeva, while still on those injections we started Provenge finished that still on shots but then PSA started rising in 2017 so put on Zytiga and Prednisone now Mar 2019 PSA elevated and doctor said no point to do Xtandi but start chemo. I'm scared and terrified for my 81-year young dad. The urologist said to do a Axumin test this was new to me since we only did a total bone scan and CT to the pelvis and abdomen in the past. And the doctor really didn't explain the test or anything about the chemo. he said let's see what the test shows? Any help? I have written before and just need any thoughts. I'm overwhelmed. My dad is naive and doesn't speak English. So I guess the less he knows the better he is but I'm shaking.
Whats the difference between the Axum... - Advanced Prostate...
Whats the difference between the Axumin PET/CT and a regular bone scan and CT scan of pelvis and abdomen
Here's a simple explanation of all the various scans:
pcnrv.blogspot.com/2016/12/...
The important questions you should be asking those doctors are:
- why do they want that scan?
- what difference could it make in his treatment?
If you already know there were multiple bone mets, I don't understand how an Axumin scan can make a difference in his treatment decision - no matter what it shows, chemo is a good idea. Consider Xofigo too.
1. Nice questions, probably useful in many pca decisions.
2. One reason for an Auxumin scan would be to make sure there are no Mets impinging on something structurally important like a vertebrae.
So if there is a Met impinging on the vertebrae (my husband L4) how problematic can that become?? Do we radiate? Can that be too dangerous an area to radiate?
If it looks potentially problematic to the doc. I would investigate cybernife sbrt therapy or proton therapy on that spot.
I believe that tall Allen has some studies that show that once it metastasies, local therapy like that isn't so useful..
a radiation oncologist can assess the safety. He may want to zap it to prevent spinal compression.
#2 is what a CT can do. Axumin doesn't provide enough detail to tell you that.
Then what does the axumin do?
It detects metabolically active mets.
So CT is good for bones.
And Auxmin is good for active soft tissue tumors,?
CT detects tissue - bones, soft tissue, etc. CT is always given together with a PET scan or bone scan to get better resolution on where the tumor is.
"mets to the bones".... ? How many is "multiple"? How about if it is only a few mets and they think SBRT is an option to each met? Perhaps an Axumin scan could help with specificity and narrowing treatment options.
"Multiple metastases" has been defined in recent studies as visceral metastases or 4 or more bone mets with at least one beyond the pelvis or vertebrae.
Yes, thanks. I was just speculating that perhaps "multiple" was few enough that an Axumin scan might help inform a localized treatment. If "multiple" is anything from four to ??? mets, and perhaps an Axumin scan showed six, seven or eight, then the conversation is a little different than systemic treatment for wide-spread mets. Certainly not my area of expertise and merely thinking out loud about how to use the imaging.
Sorry to hear of your fears and anxiety. It's perfectly understandable. I'm about 10 years younger than your Dad, and I will be facing a comparable decision when my current drug(s) stop being effective. It's not easy. My daughter worries about me, too. Meanwhile, ...
Here's the patient brochure and some other info about Axumin, if you may need it.
axumin.com/sites/default/fi...
Good Luck with whatever test results may come before the next further treatment(s).
If in doubt, give your Dad a Big Hug every time you can. I've heard that they have intangible healing qualities for both. You don't need to worry about everything all at once. "One thing at a time" is often just right.
Charles
I thought it was to see if the cancer spread to any other part of his body other than the bones so I didn’t ask and he didn’t say. So this test won’t be able to tell us anything else than the normal scans he had?
"See" and "tell us" are not good reasons to go through the test. The test is only useful if there is something you could possibly do with the results.
I’m not sure, he suggested before he wants to get dad possibly started on chemo since the zytiga is slowly starting to allow his PSA to rise so the next step would be chemo?? And he first said we would do the regular bone scan and ct of abdomen/pelvis then he said “oh let’s do this other test” he said the name and I was a bit lost came home and googled it then came here for help
If he want to see if Zytiga is failing and it's time to move on to a different treatment, he may want to compare a new bone scan to a pre-Zytiga bone scan. Switching to a different test now will lose comparability.
Olivia:
There are some doctors, with older patients, that spread chemo out over 3 weeks (1/3 a week) rather than one treatment every 3 weeks. I am not sure the 1/3 routine is as effective as a "blast" every 3 weeks but it is easier to tolerate. Ask your dad's doctor.
Best,
Craig
My husband just had the axumin whole body pet scan it suppose to be very sensitive for detecting Mets anywhere in the body for recurring psa rise or initial high dx of Gleason 9 or 10 . It’s the newest technology I hear that PSMA choline pet scan are good too. My husband was in the machine for 40 minutes had to keep in arms behind his head without moving that was the hardest part . Tell your dad to start stretching to keep his arms behind his head so the test will be easier on him my husband does weights so no problem for him but some people find it uncomfortable. Good luck .
Would you be kind enough to tell us where your Dad is located, Treatment center and Doctor(s) name(s). All this info is voluntary but it helps us help you and helps us too.
If you wish to respond please do so on another future post and not to me. Thank you.
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 03/29/2019 1:49 PM EDT
Yes I can tell u we are in Michigan a suburb 40 from Detroit he is seeing a urologist the Michigan institute of urology I don’t see how this will help anyone help us but there it goes. Thank u
Cancer spread to lungs and lymph nodes 
How do you find a good oncologist and how do you overcome the side effects of Lupron?
doc says 9-12 months more for my dad
What comes after, what comes next? 
My Dad Stage 4 Pca - MO happy to settle for PSA 30, as its not 'curative'!
