Followup MRI post PSMA scan, tumor near bladder neck?

[jjpeabody]

Last month PSMA scan reported "intense uptake left/posterior aspect of bladder in surgical bed", MRI ordered by RO reported yesterday "0.8 cm nodule in the left posterior bladder adjacent to the bladder neck corresponding to findings seen on PSMA PET/CT". I haven't run this by my RO yet or heard from him or my MO. At first glance sounded like "in" the bladder but PSMA states "surgical bed". There was no measurement about how adjacent the tumor was to neck. Is this uncommon or an increased concern for SRT, toxicity, or incontinence? Thanks as always for any insights, Jim

[noirhole]

Probably need to go to the Urologist and have them "scope" it out. I had something similar but was peeing blood. Did radiation and that cleared it uo. So if it is not angry maybe just scar tissue. Good luck.

[jjpeabody in reply to noirhole]

Thanks for your reply noirhole, I have just scheduled the cystoscopy for beginning April. Best of luck, Jim

[Justfor_]

PSMA with 68Ga radio ligant circulates via the urinary tract and as so the area around/behind bladder is poorly imaged. I guess this was the reason they sent you for an MRI. 18F radio ligant doesn't have this shortcoming.

[jjpeabody in reply to Justfor_]

Thanks for your reply Justfor. The PSMA did say surgical bed, but I think the RO did want some clearer and more definitive resolution before SRT. The way the MRI report was worded was confusing to me. I am assuming there is a tumor in surgical bed near bladder neck. I will ask RO and MO for an opinion early next week. Good luck, Jim

[Shooter1 in reply to jjpeabody]

Sounds like you are interpreting the report correctly to me... Let us know what scope shows and best luck to you on treatments...

[jjpeabody in reply to Shooter1]

Thanks a lot Shooter1

[Tall_Allen]

It is absolutely an indication for SRT or intensive hormonal therapy.

[jjpeabody in reply to Tall_Allen]

I met with MO Monday before MRI results to discuss treatment plan for ADT/hormone therapy alone; or in combination with SRT. The MO thought my addition of Zytiga to Lupron was too much initially and suggested we stay on Eligard ( I'm on 6mth shot) and stop Casodex and check back in 3 months to follow-up on PSA etc blood work. I will email him tomorrow re clarification of MRI report and further recommendations if any. I also met with urologist to obtain a cystoscopy in early April. He wanted to schedule surgery for either a sling or AUS. I told him at 1-2 pads I'm not doing any surgery at this time, current incontinence is very doable at this time, mostly 1 pad. Feeling a little disappointed with doc situation here lately, maybe just a little tired but keep going. Thanks for your reply, Jim

[Hidden]

Well jj , I think you need adt to shrink that pc out of your urology. I too was gleason 4+4 =8 no op stage #4 . Had pc tumors blocking urethra and bladder .Resulting in bi- lateral neuphrostimy tubes and a foley then stents . All while undergoing 8 weeks Imrt targeted to the pelvis plus Lupron

And another tests adt drug . Those shrank the tumors allowing me up ditch the tubes. You don’t want any part of that misery. I’ve pushed pc away for over five years now. You can also . It’ll take some poison to push it away . Also love yourself with good things to counteract the bad . Good luck and welcome!

[jjpeabody in reply to Hidden]

Thanks for your reply Lulu700 and sharing your struggle and hard fought advice. That's quite a battle you had and I'm sorry for all the misery you had to endure. Five years sounds like a solid victory, I hope so. I will continue to find out where I stand and do what I have to, the coming weeks should reveal my direction. Thank you again, your post and the others help to know we are not alone. Best of luck, Jim.

[Hidden in reply to jjpeabody]

I was one of he lucky ones to not know much misery prior to APC . Now I t’s just part of the deal. We Do what we can to limit side effects from the treatment. You must try to strengthen your bones and heart . Weight bearing exercise and simple bone nutrients can help stave off osteo. I was not able to save my bones and slipped into painful osteopenia. I’ve taken 4 .. 6 months shots of prolia along with two years of bone nutrients and my latest dexa bone density scan

showed a 10% improvement in bone loss. We can tell you things that the doctors won’t. Welcome to the club that no one really wanted to join. Strength in numbers and knowing that you are not alone in this. Take care .. Scott🌵

[jjpeabody in reply to Hidden]

Thanks Lulu700 for your reply and encouragement. I did see Dr. Singh initially and sought second opinion with Dr. Bryce who was originally my first choice, but it may be that Dr. Singh has a more aggressive approach, especially with high risk recurrence after RP, and that is more my thinking. We will see. Thanks again for sharing your doc and experiences. Best of luck, Jim

[Hidden in reply to jjpeabody]

DrSingh saved my life. Whoever you’re with at Mayo will be great . My uro wanted six months of chemo. Singh got me on the tak -700 trial with Lupron and 8 weeks imrt.. we love dr Singh .

[jjpeabody in reply to Hidden]

Hi Lulu700, it appears you are in AZ and reference Mayo (assume AZ) in a positive light. You had some challenging treatments that had successful outcomes. My MO is Alan B. and RO is William W. If you had your treatment there can you share your MO and RO, if you prefer not to that is no problem. I am rethinking my possible options. Best of luck going forward, Jim

[Hidden in reply to jjpeabody]

My prostate cancer specialist was Dr Singh from U of A med center . He is now at Mayo Scottsdale . I wasn’t seen

At Mayo . I’m on Medicaid Medicare and Ssdi . I believe that You shall receive the best care there. Live more healthy than ever before . ✌️

[dadzone43]

The radiologist says "in" rather than on. In either case, it is a disappointing finding and will need additional treatment.

[jjpeabody]

Thanks dadzone43, I just sent an email to MO who had been waiting for report results to seek a confirmation from him. Thank you and best of luck, Jim

[Doseydoe]

JJ, my PCa marched into my bladder and closed off the entrance where my left kidney empties into the bladder via the uterer. Chemo and ADT had little effect. It is not able to be detected on PSMA PET Scans as the tracer is excreted out in the urine and you end up seeing red on red when you focus on the bladder image. What worked for me was a TURBT and Radiotherapy. All the best, 😎 DD.

[jjpeabody in reply to Doseydoe]

Thanks Doseydoe, I would have never imagined anything like that and your post gives me good information to draw upon. I would hope that would possibly show up on future MRIs. Did the radiation into your bladder drastically effect incontinence/toxicity issues, it seems like it would but I do not know. Thanks again and best of luck, Jim

[j-o-h-n]

Best buy on depends..... Costco..... They can deliver them to you in a discreet carton.....Best of whatever!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/25/2021 5:42 PM DST - Greek Independence Day OPA!

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

Thanks for your reply John. Best of Happy Greek Independence Day!