Axumin verses Bonescan

[JDKotter]

I had a bone scan last year at Gleason 9 diagnosis.Margins, Seminal vessels, 2 lymph nodes,

This first BS showed radiotracer uptake in a couple of ribs. Further testing At MD Anderson ruled out rib mets through MR and CT scans.

This year in January, I had Axumin scan (PSA reoccurrence was 4.3 in January after RP in August 18) The scan showed mild radiotracer uptake in my Ramus bone but no Rib uptake.

I had another bonescan this week (my PSA is now .02) which showed no Mets in the Ramus (suspected in Axumin) and decreased uptake in the couple of Ribs that were suspect in last years BS. Probably due to Zytiga and Lupron therapy?

Question?

Why have another bonescan if Axumin is more sensitive? In other words how can BS rule out the Ramus uptake w Axumin?

Wouldn’t another Axumin scan have been a better diagnostic test to confirm the Ramus uptake? I’m guessing Axumin would not be effective w my PSA at .02

Also, if MD Anderson ruled out bonescan Rib Mets, why would the 2nd bonescan a year later show a decrease in radiotracer uptake if it wasn’t Mets? Note: The bonescans were at different facilities, different manufacturers maybe that’s why?

My current PSA is .02 (zytiga/Lupron

I have 6.5 week of Radiation starting in 7 days.

Thoughts?

[Tall_Allen]

You are right that the bone scan is inferior to the Axumin scan. But there is no value in having any kind of scan while Zytiga is working so well. The whole purpose of your hormonal therapy is to shrink the mets.

[JDKotter in reply to Tall_Allen]

Makes sense. Thank you!

[JDKotter]

Thanks Nalakrats!

[ctarleton]

Bone scans can have places on them that come and go for reasons other than cancerous bone mets. I once had a fall and jammed my elbow between scans, and the ends of my arm bones at the elbow showed up as actively taking-up the Tech-99 tracer at my next NM Bone Scan. Probably micro-fractures still healing. The next time, they were gone.

[JDKotter in reply to ctarleton]

Thank you

[rust]

Axumin is not as effective as a radioagent in bone. I believe there is an MRI agent more effective at bone imaging.

[JDKotter in reply to rust]

Thank you I’ll ask about the MR agent. I’m assuming that’s what MD Anderson scanned me with.

[dmartinaog]

Hi, I'm a Gleason 9 had the full RP last October, PE event 10 days later and pneumonia 10 days after that. October was rough. I was left with Gleason 10 margins, lucky me. I have radiation treatment #6 today 28 to go. My PSA was 1.0 after surgery and I was put on Lupron 10 post OP and I had one uptick in PSA in January, I'm getting the 3 lupron shot in a week. Things seem to be dormant, my PSA was 0.014 in last month. They want to add Zytiga in 2 weeks and stay on it for 2 years with Lupron. The radiation isn't to bad yet, I get very tired about 5 hours after treatments. I had the axumin scan done too, it was neg for any met, it did pick up something on my ribs, but I have had at least 6 to 8 prior broken ribs and other old injuries that can show up as bright spots. I've had a NM PET bone scan, axumin scan, and regular bone scan all showed negative mets.

How are side effects on Zytiga?

[JDKotter in reply to dmartinaog]

Congrats on your response to the drugs and no detectable Mets!

Zytiga can increase your blood Pressure. Mine is pre hypertension now. Fatigue is an issue but exercise really does help. Looks like you and I are in a similar state.

I wish you well!

[monte1111 in reply to dmartinaog]

Sorry you had such a crappy Halloween. Aside from having your prostate ripped out, and being slowly cooked, things seem to be going well for you. I would advise you try to avoid broken ribs and etc. for a while. I think the side effects of broken ribs are much worse than Zytiga. But that is just a guess. Enjoy.

[DeanNelson]

So the VA has ordered a Auxmin scan for me next week, they are thinking my pca has morphed into Neuroendrocrine disease. My PSA is only 0.17 is this why they ordered that scan?