I am reading this forum every day and getting very valuable information. Thank you so much. My hats off to all of you for sharing your experience and knowledge over here and providing much-needed compassion to each other.
Age 73. First diagnosed with advanced PCA in October 2019.
Biopsy results: 5 of 12 GS 10, 2 of 12 GS 9, and 5 of 12 Benign.
Scans Results: Only one Met Increased uptake in S1.
Genetic test: negative
My case was reviewed by three MOs and it was concluded that although I have a high Gleason score, based on CHAARTED and LATTITUDE I have low -volume low-risk disease (no visceral involvement, 1 site of bony disease). So it was recommended to follow the STAMPEDE trial.
1)Lupron shot every 3 months effective December 2019.
2) Abiraterone 250 mg with a low-fat breakfast
3)Radiation to Pelvic 4 weeks
04/14/20 PSA<0.03, 06/09/20 PSA<0.03, 07/31/20 PSA<0.03 & 09/30/20 PSA<0.03, 12/1 PSA<0.03, 2/1 PSA<0.03, 4/1 PSA<0.03.
Testosterone <3 ng/dl
Bone Scans: 05/02/20 & 09/02/20
Less uptake in S1. No evidence of new bone metastasis disease.
Bone Scans 03/19/2021
Tracer uptake associated with sclerosis in S1 Slightly less pronounced compared to the prior exam. There is no new focus of tracer uptake suspicious for new osseous metastatic disease.
Side effects due to ADT: Very little. No Fatigue, no hot flashes, no weight gain.
Exercise: Walking 5 miles/day + workout with a trainer
Diet: Plant-based + Fish every other day
With these results shall I go for scans every 6 months or every year? One Oncologist says 6 months, the other says every year. How about PSA testing still every 2 months? Thank you to all of you.
I do not think you are cured. A PSMA PET/CT will show additional lesions the bone scan cannot detect. You have a Gleason 10 which puts you in the very high risk group. I get a PSA test every month to monitor my tumor closely. So I would keep the two months in your case. Also, you may want to get a PSMA PET/CT instead of a bone scan to get a better understanding where your tumor currently is.
I didn’t say I’m cured but according to Doctors it has gone into remission now. At least let me enjoy beautiful sunny day today rather worrying about snowy bitter cold day of next January.😀
But for a psma pet-ct scan he would have to allow his psa to increase to at least 0.5. I don’t think that would be a good idea for him now.
This does not apply if he does ADT. ADT reduces the PSA value but not the PSMA expression. ADT shrinks the tumor so you may see less with a PSMA PET/CT though.
My understanding, as is that of my MO at MD Anderson is that PSMA Pet-Ct scan resolution is very poor unless you have a significant PSA expression, at least 0.5. This is clearly shown in a chart in the following link:
This was confirmed to me by Dr. Czernin, head of the imaging division at UCLA, who I interviewed prior to my PSMA scan there.