PMSA PET SCAN

[Andrevz]

Hi Guys

I have been on Xtandi and Firmagon for 18 months now

I gave been treated since 2913 for PC

My PSA has increased from 5 to 10.2

Oncologist has decided to send me for the PMSA PET scan.. what is to be determined by this?

Please advise

[GP24]

The PSMA PET/CT is the most sensitive PET/CT for PCa. It will show where your lymphnode, bone or visceral metastases are and if you have a recurrence in the prostate bed. Once you got the result, your doctor may discuss with you if these lesions can be radiated or if you should continue with hormone therapy combinations.

Of cause there will be metastases too small to be detected and there are, usually a few, lesions which do not express PSMA and thus cannot be detected with the PSMA PET/CT. With a PSA of 10.2 you could get an FDG-PET/CT as well to compare the results.

[Tall_Allen]

It will show some of your smaller metastases. Perhaps he is trying to determine whether it's time to give up on Xtandi, and start you on docetaxel? It's a good question to ask your oncologist.

[tango65]

It will show if there are metastases expressing PSMA. If the PSA has been increasing during ADT and Xtandi cancer is castration resistant.

If there were less than 5 metastases they could consider direct treatment with SBRT or similar. If there were more mets, trying to control the cancer with chemo seems to be the prefer sequence instead of trying another new anti androgen.

You could qualify for Provenge a vaccine offering a survival advantage and you could discuss with your MO about this vaccine.

There are clinical trials for modified niclosamide which could make the cancer to respond to Xtandi again. Modified niclosamide is absorbed in the gut and it can reach therapeutic levels in blood.

clinicaltrials.gov/ct2/resu...

A possibility outside the SOC is to get treatment with Lu 177 PSMA in a clinical trial or abroad if possible financially and you are willing to travel during the pandemic.

clinicaltrials.gov/ct2/resu...

Discuss having biopsies of the mets if possible or a liquid biopsy. They could study the genome of the cancer and determine if there are mutations which could make the cancer susceptible to treatment with drugs such as olaparib, rucaparib, keytruda and similar drugs

[GP24 in reply to tango65]

If you have up to 10 oligometastases you can take part in this trial:

clinicaltrials.gov/ct2/show...

You forgot to mention that you can use Xofigo to fight bone mets.

[MateoBeach]

Good idea to get the PSMA scan now.

[j-o-h-n]

Wow............. Great guys here!!!

Keep Posting..........

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 01/18/2021 7:52 PM EST