Which Scan to have.

[Sun1115]

OK since the PSMA scan is considered the best at this time, where can I get one . I live in Florida but could travel . At this time I am slated for a Auximin scan . My PSA has doubled in last nine months .023 , 036, 063 . I have been on Lupron for two years and PSA has been untestable . I have been treated two years ago with Chemo and Pelvis Radiation for some involvement in the Lymphnodes . Originally I was diagnosed at Gleason 7 3+4 . Thank you for sharing your thoughts.

[Sun1115]

I don’t think so . What about when it hits PSA 1 ?

[Sun1115]

Thank you Buddy

[addicted2cycling in reply to Sun1115]

scan info regarding PSA sensitivity

pcnrv.blogspot.com/2016/12/...

[Tall_Allen]

Too early for a PET scan.

[Sun1115 in reply to Tall_Allen]

Thanks Tall !

[Hidden]

68Ga PSMA PET/CT individualized detection probabilities per PSA :

PSA = 0.07 -> ~67%

PSA = 0.2 -> ~73%

PSA = 0.5 -> ~78%

PSA = 1.0 -> ~81%

PSA = 2.0 -> ~84%

ncbi.nlm.nih.gov/pmc/articl... (Table 4, Age=70, GS=3+4, ADT=yes, PSADT=270 days)

[Sun1115 in reply to Hidden]

Thank you very interesting.

[rscic]

justfor has helpful data. For some sites that do PMSA see fig 4 in the below article ..... there may be more since the publication of the below article: practicalradonc.org/article...

[Blackpatch]

PSMA PET has been widely available in Australia for about 5 years at a cost equating to US$450, and is being increasingly employed as a routine scan without all the angst of wondering if it will show anything or not.

In parallel with this availability, there has been a growing acceptance that in some men, not all, PSMA PET will throw up opportunities for targeted intervention.

Men who are sitting at low PSAs like you but with steady PSA rise are using PSMA to look for the underlying cause - sometimes they visualise an actionable target that can be irradiated, sometimes not. Given the low barrier to PSMA PET, it’s not a big decision.

I am coming off 8 months of ADT plus eSRT for BCR and remain undetectable, but am scheduled for a PSMA PET in addition to a routine CT bone scan next month because the MO wants a baseline; his usual practise is to repeat this suite of scans annually.

The cost structure of US medicine is quite different, I gather, but presumably you will eventually move in this direction once PSMA PET has full FDA approval (or has that already happened?)

Stuart

[Sun1115 in reply to Blackpatch]

Thank you Stuart . Good information to have . No FDA approval yet in USA .

[ImaSurvivor1]

There is also another new, not yet FDA-approved scan, that has been shown to be able to detect PCa at even lower PSA than the Gs68 PSMA scan. It is the F18-DCFPyL radiotracer PET/CT. It is not readily available, but I got it in June through a clinical trial at City of Hope in Duarte, CA (near L.A.). At that time they were taking patients with a PSA of at least 0.4. This scan has about a 50% chance of detecting tumors when your PSA is 0.5, and much higher sensitivity as your PSA approaches 1.0. My PSA was 0.48, but nothing showed up on my scan. I think it's worth trying any of those scans you can get once your PSA gets up to 0.5 or so, (unless you've already had too much radiation) because the chances of metastasis increases quite a bit when your PSA gets to about 1.0 or 2.0 +/-.

[Break60]

Axumin and PSMA both work better at psa of around 2.0 . I used both and they both found bone mets. Axumin is available all over since it’s fda approved and it’s free on Medicare. .For PSMA which has been found to be better you need to search for clinical trials. Hopefully it’ll be approved soon. If you can’t wait, axumin isn’t a bad choice imho. Good luck.