PSA from 2.9 to 5 in 3 months

[Grouser]

2 years ago treated with radiation for Gleason Score 7 (3+4) now increasing PSA. Bone Scan and MRI prostate, CT scan all clear. Would like to keep it that way. Would appreciate info as to what direction a 78 year old man might take at this point. Doc visit today and want to be armed a bit with some knowledge.

[Magnus1964]

I would think he is going to recommend an ADT drug. My advice would be do not let your doc start with the higher end drugs i.e. xtandi, erleada, amplitude, etc. At your age I would recommend casodex or abiratorone. Casodex is an older drug with less side effects but very effective. He may offer Lupon which would be good.

At your age if you respond well to these drugs you could avoid chemo for the rest of your life.

[Grouser in reply to Magnus1964]

So many side effects now from 3 previous primary Cancers would like to avoid more. do you think any reason at this point for another biopsy?

[Magnus1964 in reply to Grouser]

I don't think another biopsy is going to change anything.

[Grouser in reply to Magnus1964]

He recommended Eligard hope it is a good recommendation.

[Magnus1964 in reply to Grouser]

Eligard is a good recommendation.

[Tall_Allen]

After 2 years, it may just be a bounce, or it may be a recurrence. The next step is to determine which it is. You will be able to get an Axumin PET/CT scan. That will tell you what it is and where it is. If it is still in the prostate, you can have focal brachytherapy to just that place. If it is in the pelvic lymph nodes, they may be able to irradiate just that area. Both of those therapies would be potentially curative.

If the PET scan finds that the cancer has spread to bones, distant lymph nodes, or distant organs, hormone therapy may be used to manage the disease.

You have to have the Axumin PET/CT scan. Ask for it.

[ctarleton in reply to Tall_Allen]

Grouser, if you are still in the Fox Chase Temple Philly area, here's a link to a locator tool showing where Axumin PET/CT scans as mentioned by T_A may be available.

axumin.com/patient/imaging-...

[Grouser in reply to ctarleton]

At this point suggestion is that Cancer re occured is in the prostate (thick walls and nodules ) and bone scan is clear what is to be gained from Asumin PET. Happy to do it not putting head in sand (well maybe a little) .

[Tall_Allen in reply to Grouser]

Bone scan/CT is not nearly as sensitive as a PET scan.

prostatecancer.news/2016/12...

[NOCanceros in reply to Tall_Allen]

Hello Tall allen

Which is the best Axumin PET/CT or Psma Pt/Ct.

I appreciate any answer

George

[Bethpage in reply to NOCanceros]

I'm clearly not Tall_Allen, but I've seen his responses to this question before. PSMA is clearly superior, just not FDA approved yet. Might be by the end of December. My husband had the Axumin at PSA 1.0. It found nothing at all. A month later, he had the F-18 DCFPyL (trial, end of phase II at Stanford) at the same PSA. 1.0. The PSMA found the recurrence in the prostate bed, as did Dr. Kwon's C-11 choline. The two PSMAs are the F-18 DCFPyL and the 68Ga. Alan has said that he thinks that the F-18 DCFPyL is a little superior to the 68Ga.

[NOCanceros in reply to Bethpage]

Hello

I did psma /pet/ct twice in Köln (Cologne) in Germany ,last time in 2018 they found 3 spot in the lymph nodes according to that i was treated for 25 days ,nowaday i'm taking Bicalutamide 150mg,in 18/11/2020 recommendation from my Oncology to stop it and make PSA test every 3 months to see if my PSA value will increase.

It seems Psma is a good test.

George

[Tall_Allen in reply to NOCanceros]

PSMA is better, but it is not yet approved and is only available for purchase at one or two places in the US.