Evening all
After having a low 4.2 psa with a non metastatic T4 tumor outside the prostate at diagnosis, I’m wondering if doing a choline pet scan Could possibly turn up anything growing while my psa is at .04? Also saw a blood test that looked for circulating cancer cells. Will they show anything early? Is there any test worth having?
Very unlikely to show anything with that low a PSA.
The PET/CTs with the highest detection rate are the PSMA PET/CT (Ga 68 or 18 F DCFPyl) and they most probable will not show anything with such a low PSA. Circulating tumor cells and cell free DNA have a very low yield with a PSA lower than 10 and not evidence of mets in CT or bone scan.
Have my standing plane ticket for LA at the first sign of psa moving. The number I was given was .50 for first psma scan. Sounds way to high for me but if that’s it’s capability nothing to be done.
Carlo this is as good as gets for us T-4 guys. I’ve stayed under the radar over five years . Stay low ✌️
I’m not hoping for movement in the Psa for sure but thinking there is something to be tested besides that.
No,no, and no.
No sitting on the fence here. Is the thought then as soon as the psa moves slightly it’s alive and well and back on adt we go?
The "Pylarify" PET was just FDA approved today.
What and how is it different from the others?
A PSMA PET/CT may show PCa. The ADT reduces the PSMA expression but not as much as the PSA value. I had a "positive" PSMA PET/CT at a PSA value of 0.09 ng/ml while having ADT.
Because my psa was never very high I was guessing a visual issue might be found on a scan not requiring a higher psa.
Did the PSMA scan locate the cancer correctly at your .09 level?
It did show the same mets that were detected before I started ADT.
If you have a low PSA value because you began with ADT, it does not mean that the PSMA expression is too low to detect anything. The PSA value is an indicator how much PCa there is and how fast it is growing. If there is a lot of tumor, a PSMA scan will show tumor. ADT will reduce the PSA value and make the metastases shrink a bit, but the tumor which you had before starting ADT is still there, albeit a bit reduced. So a PSMA scan can detect this tumor which is still present.
If you have a recurrence after surgery or radiation you will usually have no ADT and if you have a low PSA value there will be not enough tumor to be detected with a PSMA scan. However, if you had a high PSA value because of a lot of tumor and then you started with ADT reducing the PSA value, you will have enough tumor to be detected with a PSMA scan, even though you have a low PSA value.
You could wait until the insurance pays for this scan and then get it done:
On my schedule to do just that.
looking for advice. 
I'm new to PSA issues...looking for support
Looking for hope and help - PSA over 6000
What else should we be doing
