Psma pet scan report

[Neeta12]

Pet scan result.

[NPfisherman]

Hi Neeta,

It is hard to read--size wise. It looked as if there was no Ga68 uptake anywhere and that is a good thing, however micro mets are not picked up on these scans. Also, some PCa puts out little PSMA. No guarantees with this disease, but....

If it were me, I would do the "Happy Dance" on a no detectable lesions ultrasensitive scan....Congratulations....

Don Pescado

[Neeta12 in reply to NPfisherman]

Thank you

[Tall_Allen]

What was the point of having it while on hormonal therapy?

[Neeta12 in reply to Tall_Allen]

Doctor's orders dear

[Neeta12 in reply to Neeta12]

He still has hip pain

[Tall_Allen in reply to Neeta12]

With his almost undetectable PSA, there was little chance of detecting anything. While it's true that there is a temporary increase in PSMA avidity when first starting on ADT, it does not seem to be long-lived. Pain or rapid PSADT increase the probability of detection, so the hip pain probably explains why the doctor wanted it.

[Patrick-Turner in reply to Tall_Allen]

High Dear Tall Allen,

I have had about 6 PsMa Ga68 PET/CT scans, and always while on ADT, and doc asked for scan because ADT was failing and Psa was above 5.0. The first scan in 2016 showed lots of Pca at PG, and two small mets in 2 lymph nodes, each 2mm dia, and these would have been entirely non detectable by a plain old CT scan. Probably, there were maybe hundreds more mets but too small to be seen. I was offered 30Grey IMRT as salvation RT to PG and 45Grey to each met, and put on Cosadex in addition to the continued ADT.

A year later, after Psa has gone below 0.4 nadir and back up to about 5, the next PsMa scan showed many more mets. I was given Zytiga, and when that failed after Psa went down to 2 then up to about 5 again, another PsMa scan showed more mets, and despite the costs the info given by the PsMa scan has been very useful. I began chemo and that failed, and had another PsMa scan before Lu177, and this time while continuing ADT I was able to get Lu177, and Psa has dropped from 25 before Lu177 to 0.41 now and I had a PsMa scan after Lu177 that could not see soft tissue mets and bone mets are healing up.

Its now pointless to do another PsMa scan because my cancer level has gone low, so PsMa avidity or SUV, specific uptake value is so low that any more Lu177 now would be a waste of dough. I had a low Psa for the amount of Psa at diagnosis, and maybe low PsMa avidity, but I seem to have had a good outcome and the scans indicate this to be the probable truth.

In 2009, age 62, I had a Gleason 9, 9 positive samples, inoperable and Psa only 6 at Dx, but Pas was 8 at abandoned open RP 4 months later.

I had to learn to live with my Pca and not seek a quick cure with a mighty pile of treatments that may have ruined my QOL. Right now, nearly 10 years after Dx, still on ADT, and 72, I am on my bicycle again and able to pedal 19km to / from hospital to discuss what next with my oncologist. One doctor said I was the healthiest Stage 4 cancer patient at the hospital.

Despite my cancer, I am living a better life than about at least 4 billion other ppl on my little Blue Planet Earth.

If I could not have got Lu177, I think I'd be near ready for palliative care now.

And to our dear Neeta12, may I say I found it impossible to read the scan results, and to allow that they need to be posted somewhere with URL and in form of .gif, .jpg, .pdf, so a single click brings them up nice and clear. But some here can read them OK, and said they don't indicate a high amount of PsMa avidity and that you have little to worry about - for now. Later on, when Psa rises a PsMa scan may show some very useful info so that treatments can be arranged BEFORE Psa goes very high. A man can't ever hope that due to some miracle that his Psa will somehow go low without medical intervention.

But I had a friend die earlier this year while waiting for Lu177. Psa was 400+,

and he got numerous mets in his liver that were big enough to be seen in CT scan and they did not have PsMa avidity, and he died weeks later, and speed of growth of these mutant Pca cells outwitted the best of doctors he had caring for him. He'd had 10 chemo shots and I think he should have stopped that after 5 shots and got Lu177 asap. It was no use continuing chemo with a rising Psa. He may have killed the cells which later mutated fast enough to kill him. He lasted only 3 years after Dx, at under 60yo, and it was a tragedy for his beautiful family.

Fighting cancer means being on the ball and acting in a timely manner, and having the best possible info from scans.

I wish you the very best of luck, and I hope Nature is kind to the man whose scans we are looking at.

Patrick Turner.

[whatsinaname in reply to Patrick-Turner]

Excellent reply, Patrick.

4 out of my 5 PSMA PET-CT scans have been taken when I was on hormone therapy. All 4 have been useful in finding out 1) where my tumors are 2) whether they have increased or decreased in size from the previous scans 3) whether new tumors have appeared and whether old ones have disappeared.

All this helps in figuring out whether to continue the treatment one is taking or move to something hopefully more effective.

[depotdoug in reply to Patrick-Turner]

I'm impressed by your response Patrick-Turner. "Fighting cancer means being on the ball and acting in a timely manner, and having the best possible info from scans." Excellent advice and wisdom Patrick-Turner.

[Patrick-Turner in reply to depotdoug]

Hi Depot doug. At what depot were you dropped off at mate?

Anyway, today I had a massage session with well practiced lady maybe 60+, so there was not much she didn't know about leg muscles, and she managed to find so many sore spots in my legs that probably have been there since I had knees replaced in early 2017, when Psa was low at < 0.5 like it is now, after abiraterone, chemo and Lu177. Well, it was most unwise of me to neglect doing stretches and this led to some serious pains in hip area and a pile of misdiagnosis by various doctors who are excellent in their field, but not very excellent at holistic medicine.

The hip pains prevented me using right leg much on bike so I have been cycling around town like a one legged cyclist with one sort-of good leg, and other leg faking it. But I have managed 140km a week and 20kph average, after doing SFA for 4 months of winter, and with the help I know will come from dealing with the delightful Old Dame the speed can only rise back to where it was 6 months ago. My mind was a bit preoccupied by cancer fixes, but I should have been more positive and got things done to fix the health of leg muscles earlier. But that's underway now, better late than never. I doubt I'll ever need a hip joint. HooRay!

Right now though, I must away to visit a mate of 80 who just had a knee done after 20 years complaining about it.

I do hope Nature will be kind and bestow on thee a little extra life force to extend your time on little ol' Earth, and make it more bearable.

Patrick Turner.

[tango65]

What was your PSA at the time of the scan? The detection rate is related to the PSA concentration and PSADT. The scan will not detect any lesion with a diameter less than 4 mm. The result is what it is, not visible lesions at this time. Congratulation.

Best of luck

[Neeta12 in reply to tango65]

PSA was 0.08

[Neeta12]

Thank you