PSMA scan shows lung nodules

[Seabird12]

My husband recently had a psma scan , I uploaded the part that bothers me the most, it’s showing lung nodules, I googled and I learned that they could be metastasis. Have you ever experienced Lung nodules due to prostate cancer ? Can ADT or radiation resolve this problem ? Are we facing a possible second cancer ? I’d really appreciate if you share your knowledge with me .

[Dett]

Hi Seabird,

When my husband was initially diagnosed with APC, the CAT scan showed a potentially metastatic lung nodule, with scarring and mild atelectasis and recommendation for follow up in three months. Needless to say, I was terrified. The nodule remains after a year with no changes. It’s not even mentioned anymore as a problem area. Hard as it is, please try not to freak out without further clarification from your doctors and other informed sources.

[GP24]

These pulmonary nodules can be benign too.

my.clevelandclinic.org/heal...

I know a patient, his lung mets were gone after six cycles of Docetaxel.

[Hidden in reply to GP24]

That happened to me. They weren't sure if they were cancer. My doctor didn't think they were, but wanted to make sure. I said, "I'm doing chemo so if it's lung cancer, we're treating it." She said "Well, it's not first-line chemotherapy for lung cancer, but it is second-line so Ok." Rechecked after chemo and they were gone. Rechecked again recently, still gone. Who knows, just glad they are gone.

[Shanti1]

Hi Seabird, My husband also had multiple pulmonary micronodules show up on the PSMA scan. They were not PSMA avid, but were picked up by the CT. The CT that was done along with the PSMA scan was a "High Resolution CT", which means it takes thinner image slices through the body (I think every 4mm instead of 6mm, but I not sure on that). Anyhow, this means it is more likely to find nodules that may not have been detected by previouse CT scans. We are also not sure if the nodules are cancer but my husband was off ADT at the time and has started again. We are going to get another high resolution CT in another couple of months and see if the nodules have changed in size.

[Cynthgob]

My husband had lung nodules as well. 3 years ago they mentioned them and now they don’t bring it up. They never grew. Maybe we all have lung nodules?

[Magnus1964]

They may be Pca mets or not . I had these nodules show up in a scan . My research doctor had me do the Provenge treatment. The nodules shrank and have stayed dormant since. That was 5 years ago.

[Tall_Allen]

That sounds like the CT scan and not corroborated by the PET scan. If so, they are most likely benign lung nodules (which are common). Be careful about second-guessing the radiologist.

[PinkOrangeRed in reply to Tall_Allen]

A lung nodule can show up without a marker on a PSMA PET scan. I had the same thing just last week. I had done a CT scan and a PSMA PET and they both showed up a 5mm nodule and a couple of smaller ones on my lungs. I am not that worried yet. For past year I've had a PSA of about 6 with low free % and I've now had a biopsy and a PET PSMA say there is no visible cancer yet. My CEA swings between 4 and 8. I dunno maybe I am just a producer of inflammation markers! Let's see whether this nodule grows at next scan.

[immunity1]

The Fleischner Society recommendations are that when multiple nodules are detected and persistent on the follow-up scan, the most suspicious nodule should guide further management. Suspicious imaging features to consider include interval growth of a solid component that is 6 mm or larger, spiculated margins, interval increase in density, or a new microcystic component 5. Persistent part-solid nodules with solid components ≥6 mm should also be considered highly suspicious. The presence of these features may prompt further diagnostic evaluation rather than continued follow-up according to these guidelines, which stipulate that micronodules (<6mm in diameter) in isolation are usually left until they are big enough to biopsy so that diagnosis by histology can be made. Of course if they are secondary mets of PC then any systemic therapy could deal with them.

[redbank]

I have a nodule's in my lungs and via a biopsy it was confirmed to be metastatic prostate cancer. It is rare that the lungs become affected. It has now been three years and still going strong in a durable remission. While they are still there they have not grown in size.

[CalBear74]

I had lung nodules in my lung and some in the left pelvic wall. A biopsy revealed that neither mass was prostate cancer. It was squamous cell carcinoma. My MO chose a triple combo chemo and immunotherapy regimen to run 12 weeks:Paclitaxel, Carboplatin, and KeyTruda. They worked like magic. But they didn’t do anything to my PSA. Good luck!

I am still taking keytruda every 21 days For an indeterminate amount of time. The company recommends an extended period of treatment.

[j-o-h-n in reply to CalBear74]

I had them from a melanoma on my neck.. keytruda is working in my lungs (at MSK)...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 8:17 PM DST

[j-o-h-n]

I had them from a melanoma on my neck.. keytruda is working...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 8:16 PM DST

[ocman]

I've been reading that the PET/CT scan has a hard time detecting nodules that are smaller than 8-10mm.