Need scan info

[Canoehead]

After over a year of undetectable PSA, I am worried about possibly undiagnosed neuroendocrine disease. The fact that my Mets were lyrtic just adds to the worry. The last few weeks I have had persistent pain in my non dominant arm, and I am ready to call my MO and ask for a scan. But what do I ask for in terms of contrast medium?

[Tall_Allen]

NEPC isn't diagnosed with a scan, it's diagnosed with a biopsy of tumor tissue. Morphologically, it looks different. It also stains for various proteins like DLL-3, ChromograninA, Neuronal-specific enolase, and synaptophysin - any one of those is not diagnostic, all of them together is. You should be aware that NEPC is very rare, even with lytic bone mets, except in very advanced disease.

[tango65]

What is your PSA? Your PSA values will determine what kind of scan could be used to identify the location of the metastases and see if it is possible to obtain a biopsy. If your PSA is 10 or higher and you have multiple bone metastases you could discuss a liquid biopsy to study circulating tumor cells or cell free DNA.