PSA Gradually increasing.

[Sun1115]

I have PC lymphnodes in pelvic area and have been on Lupron (3 months injections) for three years . In that time this has worked good and keeping my PSA undectable. However, recently PSA has gradually started to increase. The last nine months has resulted in readings of 0.23 , 0.366 and recently 0.631. I am somewhat concerned. Is it possible I need a change of treatment? Should I look into getting a C-11 Cholone scan or a Auxim scan . Or any other type of Pet scan to determine if cancer has spread . Is it too early for me to worry about it . I greatly appreciate your input . Thank you Amigos.

[Fdccs]

Hi Sun1115,

What treatments have you had other than Lupron?

[Sun1115 in reply to Fdccs]

Radiation , and Chemo about two years ago .

[tango65]

With a PSA of 0.7 you should discuss a Ga 68 PSMA or 18F DCFPyl PET/CT. The detection rate of these scans is around 70%. at that PSA The axumin scan has a lowest detection rate.

ncbi.nlm.nih.gov/pubmed/313...

ncbi.nlm.nih.gov/pmc/articl...

axumin.com/about/clinical-u...

If the scan shows metastases in the pelvic lymph nodes you could discuss getting whole pelvis radiation. If there are distant metastases and they are less than 5 it may be possible to irradiate them and see what happens with the PSA.

[Sun1115 in reply to tango65]

The radiation I had almost two years ago was pelvic radiation.

[tallguy2]

It is time for a scan. The insurance company may balk...some require you to wait until the PSA hits 2.0’or even higher. But it really doesn’t matter. You need a scan to provide information that may be actionable.

[Sun1115 in reply to tallguy2]

I agree tall guy . And that new scan Ga 68 PSMA sounds like the one I need . Thank you Tango 65 . But where can I get a good doctor that administers this scan ? I live in Florida but I am able to travel . I failed to mention I am 73 .

[tango65 in reply to Sun1115]

You could get the study done at UCLA. They charge $ 2800.

Pan Thin

Research Assistant

UCLA Nuclear Medicine

200 Medical Plaza, Suite B114

Los Angeles, CA 90095

PHONE: [phone]

FAX: [phone]

Best of luck!!!

[Sun1115]

Or are clinical trials the best way to get it . Since it’s not yet aproved by the FDA ?

[tango65 in reply to Sun1115]

There are clinical trials:

clinicaltrials.gov/ct2/resu...

clinicaltrials.gov/ct2/resu...

Revise these trials and see if you could qualify for any of them and then call the people running the trial.

Best of luck.!!

[Sun1115 in reply to tango65]

Thank you Tango

[tango65 in reply to Sun1115]

Good luck with the trials. I believe the one being done at Stanford could be a possibility for your situation.

Best of Luck.!!!

[Sun1115 in reply to tango65]

Thanks again Tango . I see a clinical trial in Atlanta, And Tampa would they apply to me . Much closer than Stanford.

[tango65 in reply to Sun1115]

Good.

Best of luck.!!

[ZackD]

I was on Intermittent Lupron for 3 years and it kept my psa low but after awhile my psa started rising and my doctor switched me to firmagon monthly injections. He did do a bone scan and a CT scan to check my progress and my radiation oncologist started me on xofigo for 6 months. My Psa is still at a 5.7 but holding for now.

[Hidden]

Discuss adding an anti-androgen (casodex or nilutamide) to your regimen with your MO.

[RayF]

Seems you should be on Zytiga or similar in addition to Lupron.

Has your doc mentioned that?

[Sun1115 in reply to RayF]

No not yet Ray .

[Lynsi13]

Also consider provenge! You're in a similar place to my dad, psa slowly rising but low without pain. You sound like an ideal candidate!

[Sun1115]

Thanks for your replies . My a doctor wants me to wait until the PSA raises to 1.0 . And wants to see me in April. He will than give me the C-11 Cholene scan at this time and than go from there . And meanwhile he wants me to stay on the Lupron. My question is should I wait or address issues now . Tks

[RonnyBaby]

I recall during my radiation treatment, that the maximum dose was used with the prostate gland itself and a reduced dose (around 50 %) was used in the pelvic area.

I was node positive at the Dx, so the plan included pelvic node radiation as part of the initial treatment.

More radiation could be tried in the pelvic area but I'm not sure if that is part of the SOC, seeing as BCR may be indicated.

The 'pros' in your medical team will have to guide you through the next phase of treatment.

It is important that you trust the team that has been supporting you. Even better, would be a referral to an appropriate, qualified specialist or consultant.

Thankfully, we have several members who offer good advice based on real time experience with the advantage of having seen numerous situations arise where reliable advice was needed and taken.

It appears further testing is indicated. Hopefully, the resources are available to allow that to happen ASAP.

The good news is that you have been monitored over the last few years, so it is possible to start pushing back against further disease progression.

Wishing you the best, moving forward ....

[Sun1115 in reply to RonnyBaby]

Thank for your reply . So waiting until April kind of risky .

[j-o-h-n]

From the NET: FLORIDA

Axumin Imaging Center Directory

If you're a healthcare provider and are not able to find a local imaging site, or have other questions about a specific imaging center, please contact Siemens Healthineers' PETNET Solutions Customer Care at 877-473-8638.

The imaging centers and physicians included in this list are those who have given their consent to be identified. It is not an exhaustive or complete list of all sites that offer imaging services using Axumin. This information is provided as a reference for referring physicians and is not intended to be an endorsement by Blue Earth Diagnostics, Inc. (BED) of the physicians or sites listed, nor is it an endorsement of BED by those sites. It is the responsibility of the referring physician to determine whether Axumin is the right option for their patients and to identify an appropriate referral site if Axumin is not available at their location.

melia Island

Ackerman Cancer Center - Amelia Island

1340 South 18th Street Suite 103

Dr. [e-mail]

Aventura

Akumin Aventura

2925 Aventura Blvd Ste 100

Jessica [e-mail]

Aventura

Unique Imaging

18851 NE 29th Ave Suite 103

Mickey [e-mail]

Beverly Hills

PET/CT Services of FL

3404 N Lecanto Highway

Todd Sandlin352-746-6888

Beverly Hills

PET/CT Services of Florida

3404 North Lecanto Highway

Cindy [e-mail]

Boca Raton

Boca Raton Regional Hospital

800 Meadows Rd

Maribel [e-mail]/

Boca Raton

Diagnostics Centers of America

8142 Glades Road

Michelle [e-mail]

Boca Raton

21st Century Oncology

21020 State Road 7 Suite 100

Lindsay [e-mail]

Boynton Beach

Diagnostic Centers of America

6080 Boynton Beach Blvd

Michelle [e-mail]/

Bradenton

Simonmed Bradenton

6215 21st Avenue West

PET [e-mail]/

Clearwater

Carlisle Inaging Center-Baycare Health System

400 Pinellas Street, Suite 101

Diane [e-mail]

Clermont

Clermont Radiology

3725 S Highway 27, Suite 104

Sheila M [e-mail]

Daytona Beach

Twin Lakes Imaging

1890 LPGA Blvd Suite 110

Lesley [e-mail]

Deerfield Beach

U of Miami - Sylvester of Deerfield Beach

1192 East Newport Center Dr.

Brian [e-mail]

Deland

ADVENTHEALTH DELAND CANCER INSTITUTE

680 PEACHWOOD DR

MELISSA [e-mail]

Fort Lauderdale

Holy Cross Hospital

4725 N Federal Highway

DeAnna Petitto954-771-8000 [e-mail]

Fort Lauderdale

National Pet Scan

6290 N Federal Highway

Tony [e-mail]

Fort Lauderdale

PET Imaging Institute of South Florida - Fort Lauderdale

2122 W Cypress Creek Road, Suite 210

Scott [e-mail]

Fort Myers

Radiology Regional Center, PA

6100 Winkler Rd.

Shawn [e-mail]

Ft Lauderdale

MRI Scan & Imaging Center

3122 East Commercial Boulevard

Robert Kagan, [e-mail]

Gainesville

Florida Cancer Specialists Gainsville Cancer Center

6420 W Newberry Rd East Wing Suite 100

Amy Broom Anna Marie [e-mail]

Gainesville

UF Health Shands Medical Plaza

2000 SW Archer Rd.

Jason Norton352-265-7050

Hollywood

Akumin Hollywood

3800 Johnson St.

Jessica [e-mail]

Hollywood

PET Imaging Institute of South Florida - Hollywood

1150 N 35th Avenue, Suite 665

Gwen [e-mail]

Jacksonville

Ackerman Cancer Center

10881 San Jose Blvd.

Honey [e-mail]

Jacksonville

Akumin Imaging

2020 Professional Center Dr.

Jessica [e-mail]

Jacksonville

Southside Cancer Center

5742 Booth Road

Mark [e-mail]/

Jacksonville

UF Health Jacksonville

655 W. 8th Street

Jerald [e-mail]

Jacksonville

PRECISION IMAGING CENTERS

7860 GATE PARKWAY

Darren [e-mail]

Jacksonville

St. Vincent's Medical Center Riverside

1 Shircliff Way

Kevin J. Doyle [e-mail]

Jacksonville

SouthPoint Cancer Center

7017 A C Skinner Parkway

Natalie [e-mail]/

Jacksonville

BAPTIST MEDICAL CENTER SOUTH

14550 Old St. Augustine Road

Nicholas [e-mail]/locations/me...

Lady Lake

Sand Lake Imaging at Lady Lake

809 County Road 466 Suite 400

Chrystal [e-mail]

Lakeland

Hollis Cancer Center

3525 Lakeland Hills Blvd.

Kristine Hall863-688-2334 x711

Lakeland

Radiology and Imaging Specialists

1305 Lakeland Hills Blvd.

Amanda [e-mail]/

Leesburg

Florida Cancer Specialists Leesburg South

601 E Dixie Ave Suite 101

Amy [e-mail]

Leesburg

Lake Medical Imaging

801 E. Dixie Avenue Suite 104

PET [e-mail]

Miami

Unique Imaging

3801 Biscayne Blvd., Suite 110

Mickey [e-mail]/

Miami

University of Miami Hospital and Clinics

1475 NW 12th Avenue

[e-mail]

Miami Beach

3T Radiology & Research

310 W 41st Street

Jorge Tamayo305 [e-mail]

Naples

Radiology Regional Center, PA

700 Goodlette Rd.

Shawn [e-mail]

Ocala

Clinical PET of Ocala, LLC

3143 SW 32nd Ave.

Dr. Ganesh [e-mail]/

Ocala

PET/CT Services of Florida

1541 SW First Ave, STE101

Art Ammirati BS AS RT(R)(N)(CT)[e-mail]

Ocala

Medical Imaging Center at WIndsor Oaks

1901 SE 18th Avenue Bldg 200

Tonya D'Ambrosio R.T. (R)[e-mail]

Ocala

PET/CT Services of Florida

1541 SW 1st Ave STE 101

Cindy [e-mail]

Ocoee

SimonMed Ocoee

10125 W. Colonial Drive, Suite 114

PET [e-mail]

Orange City

Mid Florida Cancer Centers

2776 Enterprise Road #100

Harish Gowda, [e-mail]

Orange Park

Akumin Orange Park

2020 Professional Center Drive

Jessica [e-mail]

Orlando

Sand Lake Imaging

9350 Turkey Lake Road, Ste. 100

Valery R Crespo-Matos407-363-2772 [e-mail]

Orlando

SimonMed Imaging - Orlando

51 W. Kaley St.

PET [e-mail]

Orlando

ORMC/UF Health Cancer Center

1400 Orange Ave 1st Floor

Elaina [e-mail]

Palatka

Cancer Center of Putnam

600 Zeagler Drive

Dr. Anand Kuruvilla, MD, [e-mail]

Palatka

Cancer Center of Putnam

600 Zeagler Dr

Shari [e-mail]

Palm Coast

Town Center Imaging

21 Hospital Drive Suite 130

Lesley [e-mail]

Pembroke Pnes

PET Imaging Institute of South Florida - Pembroke Pines

603 N Flamingo Road, Suite 155

Gwen [e-mail]

Pensacola

PET/CT Imaging Center of NW Florida

5149 North 9th Avenue Suite 124

Kirwan [e-mail]

Pensacola

Woodlands Medical Specialists

4724 North Davis Highway

Imaging [e-mail]/

Pensacola

The PET/CT Imaging Center of Northwest Florida

5149 N. 9th Avenue Suite 124

Kirwan [e-mail]

Pinellas Park

National Imaging Specialists

6600 66th Street N, Suite B

J.R. [e-mail]/

Plantation

Akumin Plantation

8300 W. Sunrise Blvd.

Jessica [e-mail]

Poinciana

SimonMed Imaging - Poinciana

875 Cypress Parkway

PET [e-mail]

Port Charlotte

Akumin Port Charlotte

2625 Tamiami Trail

Jessica [e-mail]/

Rockledge

Rockledge MRI and PET Center LLC

1910 Rockledge Blvd. Ste 102

Angel [e-mail]

Sarasota

Partners Imaging Centers

1250 S. Tamiami Trail Suite 101 & 103

Nigel de [e-mail]

Sarasota

Imaging for Life

3830 Bee Ridge Road

Ged [e-mail]

St Augustine

Precision Imaging Centers

1000 Plantation Island Drive, Suite 1

Darren [e-mail]

St Petersburg

Rose Radiology - St. Petersburg

4551 4th St North

Amber [e-mail]

Tallahasse

Tallahasse Diagnostics Imaging

1600 Phillips Rd.

LaCora [e-mail]

Tamarac

Impressions Imaging, LLC

7180 N University Drive

Nadia [e-mail]/

Tampa

National Imaging Specialists (VyMed)

10010 N Dale Mabry Hwy., Suite 160

J.R. [e-mail]/

Tampa

Rose Radiology Center

5107 N. Armenia Ave

Amber [e-mail]

Tampa

Tower Radiology

4719 N Habana Ave

Erin [e-mail]

Tavares

AdventHealth Waterman Imaging

1922 Salk Ave

Sterling [e-mail]

The Villages

Lake Medical Imaging

1400 US Hwy North Suite 510

PET [e-mail]

Titusville

Parrish Medical Center

951 North Washington Avenue

Dawn [e-mail]/

Vero Beach

Vero Radiology Associates

3725 11th Circle

Ken [e-mail]

Wellington

Diagnostics Centers of America

2565 South State Road 7

Michelle [e-mail]

Wesley Chapel

Florida Hospital Wesley Chapel

2600 Bruce B. Downs Blvd.

Sandy [e-mail]/wesley-...

West Palm Beach

Florida Cancer Specialists Good Samaritan Flagler

1309 North Flagler Drive

Amy [e-mail]

West Palm Beach

Diagnostics Centers of America

1572 Palm Beach Lakes Boulevard, Suite 2

Michelle [e-mail]

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/06/2020 8:50 PM EST