PSMA scanner: Hello All, My Onc, Dr... - Advanced Prostate...

Advanced Prostate Cancer

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PSMA scanner

Survivor1965 profile image
44 Replies

Hello All,

My Onc, Dr Bryce at Phx Mayo, says most hospitals will have PSMA scanners by the end of the year. Also 90% of us will emit PSMA on the scan which will make us candidates for LU 177 when it’s hopefully approved later this year. Just wanted to throw this out there. Have a great day.

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Survivor1965 profile image
Survivor1965
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44 Replies
6357axbz profile image
6357axbz

Are you saying mHSPCa patients will be eligible for Lu177?

Survivor1965 profile image
Survivor1965 in reply to6357axbz

Hi, I’m not sure if the hormone sensitive group is eligible. I think there are others here better suited to answer this. ??I do remember him saying the eligibility questions regarding the FDA are still being answered, as in the who’s and the when’s.

ragnar2020 profile image
ragnar2020 in reply toSurvivor1965

Greetings, Improve PCa imaging sciences which have sucked for a long time, and then support targeted tumor treatments with micro radiation delivery. The FDA is glacially slow, but with luck, it’ll get there with approvals while some of us are still alive to benefit from the newer procedures. Neither of these developments are actually new; they have been available around the world in countries with national health care for several years. But in the USA, the capitalistic medical industrial biz makes the rules and the FDA and other agency move carefully not to piss off the powerful.

Keep the faith that the good guys will eventually prevail.

JPD

cesanon profile image
cesanon in reply toragnar2020

"capitalistic medical industrial"

That's not actually fully accurate.

The rules are governmental rules. They are driven in large part by the political party whose health policy is: "Don't get sick, and if you do, die quickly."

Strangely, the demographics of this forum would indicate that approximately 2/3 to 3/4 of the (cranky elderly male) patients who frequent this forum voted for that very party in the last election.

Go figure. LOL

maley2711 profile image
maley2711 in reply tocesanon

I understand why you say that, but I'm not sure a survey would show that result. I am actually confused by your statement...you say " The rules are governmental rules. They are driven in large part by the political party whose health policy is: "Don't get sick, and if you do, die quickly."

please clarify. I thought it is generally the truth that Ds support more regulation, Rs offer less regulation, and you say party that supports more regulation also hopes men will die quickly....thus implying Ds support the earlier death of fellow Americans?? I'm mostly D on many issues, sometimes differ..but Ds do often disagree on various topics, contrary to what political advertising may tell the American public. Defunding police is the most glaring example......LARGE majority of Ds never supported such a thing, but you'd think it is the general D policy??? Just as weknow the large majority of Rs certainly didn't endorse what happened Jan. 06 at the Capitol.....yet some political opponents do make that claim of majority R support for the Capito invasion by "tourists" .

So, just to be clear, I know NO Ds who support "die quickly" !! Though I know some who actually believe that is the R position...which again is nonsense...... I know no such R, and there are several in my family!!

Hopefully no more political insinuations from those participating here.

cesces profile image
cesces in reply tomaley2711

"Don't get sick, and if you do, die quickly."

That is what you get when you defund health care. That is the result when government exits health.

Also when government exits health care you get uninformed ignorant consumers buying products they don't understand from vendors who have all the info and who refuse to share that info.

Markets like that are assured to generate fraud, because markets like that cease operating like markets.

See generally quackwatch.com

Also see which party has consistently blocked medicare from negotiating drug prices. That's the party that angry old men with prostate cancer generally vote for.

maley2711 profile image
maley2711 in reply tocesces

I'm not R...definitely not! till, what do you mean "government exits healthcare" ?

Huge numbers of Amerians are covered by government programs, as you well know. NIH receives large amount s of funding......some believe should be more, some don't. When I successfuly made my appeal to Kaiser re coverage of fusion biopsy for someone who had never had an initial biopsy...do you think I would have had similar success appealing to the SS or other government agency?? There are pros and cons to any type of healthcare system....but the wealthy will aways have beteraccess to the best of course...if outlawed here, they will fly somewhere else. My Mom, who was middling wealthy, blieve evryone deserved equal access, and no more. But most folks with resources will not go along with that. In fact, on the PCa forum, you will find men limited by resources, and others with apparently unlimited resources.

monte1111 profile image
monte1111 in reply tomaley2711

The Ms just want everyone to die slowly. Velly, velly slowly.

maley2711 profile image
maley2711 in reply tomonte1111

Ms???

monte1111 profile image
monte1111 in reply tomaley2711

The independent party of Ms. Ds plus Rs equals Ms. Qs are just Qs.

maley2711 profile image
maley2711 in reply tomonte1111

so..Ds and Rs want you to die slowly..what the hell??

monte1111 profile image
monte1111 in reply tomaley2711

Yes. And j-o-h-nS would prefer clowns twist slowly, twist slowly in the wind.

cesanon profile image
cesanon in reply to6357axbz

PSMA has some significant side effects.

In fact they limit the total number of life time treatments because of that.

So they will likely limit its use to patients for which other less dangerous treatments no longer work.

Survivor1965 profile image
Survivor1965 in reply tocesanon

Like me? 21 chemos, failed Zytiga, will eventually fail Xtandi. ?

cesces profile image
cesces in reply toSurvivor1965

Yes

monte1111 profile image
monte1111 in reply toSurvivor1965

21 chemos? And only one punctuation error? I am impressed. Hang in there! I am only 13 behind you. Hope you will be Survivor2065.

Survivor1965 profile image
Survivor1965 in reply tomonte1111

Punctuation error? I’m fighting g 4for mi life and your’ dinging mi on punktuasion? For fucks sake 😳

monte1111 profile image
monte1111 in reply toSurvivor1965

Mi laff of thee day. Four focks sake. At leest ur spellng ist grreat.

🙂

Survivor1965 profile image
Survivor1965 in reply tocesanon

If PSMA sensitive detected in the scan, what is the treatment?

cesces profile image
cesces in reply toSurvivor1965

Treatment can be anything.

Psma is both a diagnostic technique and a Later stage treatment technology.

Shooter1 profile image
Shooter1

Especially those of us with a BCR and fast rising PSA.

Cooolone profile image
Cooolone

PSMA is the contrasting agent, the machine used for imaging is a standard CT Scan!

So you're talking about the F18 PYL contrast?

Also, receiving the treatment off script, ie, approval (FDA) for mHSPC patients in all probability isn't happening here in the U.S., we would need to go somewhere under compassionate clause! As far as my understanding is... And this is something is completely disagree with! Yes, in a personal level of course...

Patients, especially once entering the Stage IV, incurable realm, should be able to voluntarily select treatment if in agreement with their oncologist! Especially when venturing outside the SOC, as an individualized treatment modality for those rare or non-standard presentations of disease! When those patients are downgraded and shoeboxed into those neat little groups for SOC application, it does a disservice to them. Treatment is and should be about choice, and the FDA limits those available choices too much IMO.

Anyways...

Best Regards

Survivor1965 profile image
Survivor1965 in reply toCooolone

This post confuses me. I thought PSMA is a protein on the surface of most prostate cancer cells and the machine is a PET scanner. And of course the contrast is the F18. Are you a doc, because you are telling us something completely contrary to what the head/chair of oncology at Mayo told me. He says we are getting it then I trust him. What info do you have that this isn’t happening here in US/FDA?

Cooolone profile image
Cooolone in reply toSurvivor1965

The contrast agents are what attached to the PSMA protein, yes. But the machine that is used is a standard CT Scanning machine. Sorry if this was explained any different to you. And anyone is free to correct me if I'm wrong!

I've had 2 PSMA tests (G68) and this is what was explained to me, and what I have read throughout all the material I've found. If you read the studies you'll find absolutely no mention of any different machinery being used, just the different contrasting agents.

My being a doctor bears no significance, sorry. And that could be interpreted as a subtle slight, although I take no offense. It's the contrasting agents which differ, and the F18-PYL is a plus because it's half-life is almost 2x that of the G68 agent. This will allow it more expanded use due to its ability to be manufactured off-site and shipped while still stable. The G68 is still the gold standard for sensitivity, but this new approved contrast agent is going to change things because so many will now have access to it for sure. As by example, you're being told it will be available soon. It is possible that they have equipment that is older and not sensitive enough for the PET imaging. The equipment noted on my scans is a GE Discovery 690.

Good Luck!

pubmed.ncbi.nlm.nih.gov/260...

Survivor1965 profile image
Survivor1965 in reply toCooolone

Sorry, didn’t mean to come off with that slight. Question, and this has been some confusion for me, is the scan, regardless of which of the 2 injections, used for detection and treatment? Or just detection? I was under the impression it treated with radiation what it found ?

Cooolone profile image
Cooolone in reply toSurvivor1965

No worries at all, mentioned I didn't take it that way ;)

maley2711 profile image
maley2711 in reply toCooolone

Here are the actual facts........

cancer.gov/news-events/canc....

So, researchers have been developing and testing other imaging agents that can find prostate cancer cells specifically in the body, Dr. Shankar explained.

As their name implies, PET-CT scans combine a CT scan with a PET scan, another type of nuclear imaging test that requires patients to receive intravenous injections of a radioactive “tracer” that can be detected on the scan.

In a PSMA PET-CT, the tracer used for the PET scan includes a molecule that specifically binds to the PSMA protein, which is often found in large amounts on prostate cancer cells. That molecule is linked to a radioactive compound, or radioisotope. The radioisotope used in the Australian trial is called gallium-68 (Ga-68).

Why the need for argument on this?? Someone's memory is less than perfect...mine certainly......so cite actual info in B/W ?

Survivor1965 profile image
Survivor1965 in reply tomaley2711

No one is arguing, certainly not me. I just asked the question. I’m so done done with sensitive people.

maley2711 profile image
maley2711 in reply toSurvivor1965

most folks are sensitive...maybe in different ways, on different days,etc. MHO. with internet communication, so many times misunderstanding of the composer's intent?

For instance, I reply to someone " Did you REALLY mean that" It might be , and probably would be, an innocent question. but the receiver might interpret a different way? Happens all the time with my sister, unfortunately.

Cooolone profile image
Cooolone in reply toSurvivor1965

Definitely not an argument, is as all are here, great discussions. Not sure why someone would interpret the above as arguing? Lol

in reply toSurvivor1965

Hi Survivor! We have the same guy, he told us Mayo was hoping to have it in the 4th quarter, but possibly could extend the wait until after the first of the year. We trust him too, it's coming just not a definite date yet. Stay well!

nonm profile image
nonm in reply toCooolone

FDA's cold take on the stage 4 : Why waste?

Hi survivorI am also a patient of Dr Bryce and Phoenix Mayo. What does the new scan do? How are you doing in your battle?

Tom

Survivor1965 profile image
Survivor1965 in reply to

Doing very well, so we’ll in fact they cannot explain it. My understanding is 90% of us have prostate cancer cells that emit a prostate specific membrane antigen PSMA protein that lives on the surface of the cell. The isotope they inject adheres to this PSMA.

My question now is does this scan treat or only detect?

Cooolone profile image
Cooolone in reply toSurvivor1965

Detection only, but if PSMA sensitive (scan works), eligible for PSMA targeted therapy!

Survivor1965 profile image
Survivor1965 in reply toCooolone

Ok that’s the question I have.. if PSMA sensitive (which my doc says 90% are) what is the targeted therapy? How and when does this targeting therapy work? During the scan? After in another scan? More injectables? Thank you Cool

Good news for you. I just finished five sessions of chemo at the MayoAnd slowly recovering from all the side effects. My numbers have come down significantly from a PSA of 15 5 to 0.28. Really hope it stays that way for a while or longer.

More scams this week.

Survivor1965 profile image
Survivor1965 in reply to

I’m happy for you!!We are buying time!

Every day with my wife, kids, and grandkids is medicine.

Keep the faith brother! 😎

in reply toSurvivor1965

You too Brother. I tease Dr Bryce that I am ruining his graphs and charts because I've been fighting this beast for 19 years.

Survivor1965 profile image
Survivor1965

If PSMA sensitive after the scan is the treatment LU 177?

Cooolone profile image
Cooolone in reply toSurvivor1965

I can be in the right circumstance. The PSMA scan is a detection method that lets the cancer to be seen. It is a diagnostic tool. Along with others, it would be used to stage and prognosticate the condition of the patient. When all factors are considered, then a treatment plan that would be best for the patient could be proposed. And dependent upon the staging, previous therapy, health and some other factors, would all go into that consideration. But yes, if the patient exhibited sensitivity to the PSMA agent, it would indicate that the LU-177 therapy could be an option at the appropriate time.

Best Regards

Survivor1965 profile image
Survivor1965 in reply toCooolone

Thank you. But treatment is not at time of the diagnostic, right,

Cooolone profile image
Cooolone in reply toSurvivor1965

No, there is time for the scans to be viewed and then shared with your team and they will look them over and afterward discuss with you. Then a determination can be made, more tests ordered or treatment planned.

dadzone43 profile image
dadzone43

As they say: from his mouth to God's ears.

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