I don’t understand where I am supposed to post here. PSMA scan is attached and my oncologist says it is in the pelvic bone? I’ve just got back in UK from Japan and don’t see onco until Wednesday. Does anyone understand where I should post on this site?
Where should I be? : I don’t understand... - Advanced Prostate...
Where should I be?
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konichiwa12
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This post is fine. You have to go by the radiologist report, not the pictures.
Good luck on Wednesday. Let us know how it goes
2 smiling images -- and a 3rd on your face let's hope.
Richard,
your oncologist can only read the written report just as you do. To interpret the images, you have to be an RO with a special training for PSMA PET/CT images. You can make an appointment at the clinic where the PSMA PET/CT was made and ask them to discuss the images with you. Your oncologist cannot do that although he may try to. The images you have posted do not tell you anything, they are picked at random from the many images that were taken.
They usually give you a CD with the images they have taken. These are series of images in different directories which you can scroll through. If you got the written report you can try to figure out where you may find the mentioned lesions on these images. Look for the directories with the colored images, these may make some sense to you. If you are lucky, the RO has added images where he marked the lesions like this:
On the left side you see the PET image with the SUV values and on the right side the CT image which allows the RO to estimate the size of the lesions. Most ROs do not take the time for this.
Here I pasted different images of the same situation together. These were taken in a different year than the one above:
The big yellow spot is the bladder full of urine with tracer.
konichiwa konichiwa12 You should be here.....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 12/08/2019 9:23 PM EST
You are welcome to post here about PsMa scans for Pca.
The pictures you posted don't show much at all compared to those I have had with PsMa Ga68.
The radiologists written report conveys information to your oncologist or other doctors that will allow them to decide what future treatment is likely to be a benefit to you, or not be a benefit.
The written information will often describe the number of Pca mets, their size, and their PsMa avidity and also Ga68 SUV, ie, specific uptake value.
If there is high enough SUV, then LU177 therapy may be suitable for you.
I've been through all this with my oncologist last year after chemo failed, and last Nov 2018 I had high SUV with relatively low Psa at 25.0 and many bone mets with biggest being about the size of a pea. But after 4 shots of Lu177 each 8 weeks apart, and a PsMa scan 2 months after the last shot of Lu177, the scan showed no soft tissue mets and bone mets were healing up. Psa is now 0.32, so I could say my total amount of Pca is now 1.28% of whatever it was just before I started Lu177.
I have no symptoms of bone pains, or any other symptoms of Pca.
Side effects are occasional dry mouth when under stress, during hard exercise,
or when sleeping on my back.
However, I may need repeated future doses of Lu177 if my Pca begins to grow up to be a threat, and this would be indicated by increasing Psa.
So far, Lu177 has been good for me; the alternative was more chemo, which may have failed, then palliative care and I'd be very sick now.
Your oncologist needs to be fully aware of the new use of Lu177 which is a radioactive isotope of rare earth metal Lutetium, Lu, that normally is not taken up usefully in any human body. But in Pca therapy, Lu has been made mildly radioactive in a nuclear reactor, it has short half life of days, and molecules of Lu are made to gather together in large numbers at Pca tumour sites due to action of a special chemical bonding agent that reacts to the tumour's expression of prostate specific membrane antigen. This is different to Psa.
My oncologist was slow to understand the first PsMa scans and reports when they first became available in Australia in Melbourne in 2015, but both he and I quickly became aware enough about the scans and Lu177 therapy, so soon as chemo failed after 4 shots over 15 weeks, the PsMa scan showed I would get a benefit, and I was referred to Theranostics Australia to buy the therapy. I see no reason why that was not a good decision.
I'm 72, and was diagnosed with a Gleason 9 at age 62 in 2009, which was found to be inoperable. I should have died years ago, but have not.
Patrick Turner.
Hai kyodai O kangei shimasu
Welcome brother to the group that no one ever wants to be a member of.
Arigatogozaimashita ani
Hajimemashita Kaliber san, yoroshiku onegaishimasu. I am an English geordie btw! Thanks to everyone for the replies. It really helps 
I have just returned from my consultation. I am to start Abiraterone in the next few days as I was told. I recorded the conversation and there is one particularly disturbing part. My oncologist says, "this is a setback but it is something we can deal with and I am still confident that we are talking several years. I realise that is maybe not as long as you want when you are your age."
It is definitely not as long as I want!
He emphasised that the seminal vesicals had full dose RT so the recurrence there is not good. The hot spot in the bone could be treated by several different ways but he couldn't rule out the existence of micro-mets.
Merry Christmas Richard!
No one knows how long. Don’t focus on the timing; new meds and discoveries can change that quickly.
Hi everyone.
I started Abiraterone today with Prednisolone. My new PSA is 4.4 - it was 2.17 mid/late November. I now understand how serious this is...... Testosterone < 0.1 nmol/L
Based on your photo you look in great shape and I predict this won’t be your last Christmas.
You’re starting on a good medication and more treatment options are available to you in Europe then living here in US.
I remember the panic we felt many years ago when we were told by the Mayo doc to get our affairs in order. It is an opportunity to live to the fullest what time we have on this earth.
Thank you very much mjbach, have a wonderful Christmas and a happy new year!
Since starting on Abiraterone before Christmas I get my PSA checked every 2 weeks (plus a load of other checks). I started training on my bike again the last 2 weeks and want to know if there is any risk of this increasing the PSA from racing saddle pressure around nether regions! Should I not use bike the day before or is it OK?
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