Result of PSMA /PET/CT

[NOCanceros]

Hello Good People

Statement for GS PSMA PET-DT performed 2021-06-18 at the University Hospital. Assessment: Suspected kidney tumor. Two new lung nodules apical in the right lower lobe. Some suspicion of malignancy, however, they can also be intrapulmonary lymph nodes. No detectable metastasis with increased PSMA expression.

PSA 0.99.

Assessment

Continued PSA increase. No evidence of distant metastasis from prostate cancer.

Measure

Planned actions:

The patient is placed on the next MDK for signage of PSMA-PET and a position on the reinstatement of hormone therapy.

Nice healthy summer time to all of you

George

[Tall_Allen]

How did a kidney tumor show up on a PSMA scan that is excreted from the kidneys? Perhaps ask for an FDG PET scan.

[CoyoteGuide in reply to Tall_Allen]

Tall_Allen, Any PET Scan can see sugar-based 'hot spots' caused by the natural biological processes in the body. The various radioactive tracers added (PSMA, Axumin, etc.) for prostate cancer PET Scans are MORE reactivate to prostate cancers and highlight them better than just the highlight from the non-prostate PET Scans.

I had a false-positive Axumin PET Scan in January 2021 that indicated two 'hot' lymphnodes. Subsequently I had surgery to remove them, and six more in the area. The pathology on all of them came back benign.

Post surgery and pathology review of my Axumin PET Scan and the pathology were all done correctly. So, yes, I had an unnecessary surgery but at least I know there isn't prostate cancer metastasis in that area.

[Tall_Allen in reply to CoyoteGuide]

I'm sorry, but you've got that wrong. PET scans are specific for the uptake of the radioindicator used. Ga-68-PSMA-11 doesn't indicate tumors that metabolize glucose, and FDG doesn't show PSMA expression. Of course, it's possible that a tumor expresses PSMA and it metabolizes glucose - but that is rare in prostate cancer, and a single PET indicator cannot tell you that. It is much more likely that a tumor that expresses PSMA metabolizes proteins (Axumin) and fats (Choline). In any case, a radioindicator that shows PSMA expression tells you nothing about the tumor's metabolics.

False positives are certainly possible with any diagnostic test.

If you wish to better understand how they work, you might want to read this:

prostatecancer.news/2016/12...

[CoyoteGuide in reply to Tall_Allen]

Sorry but the base functionality of a PET Scan does exactly as I described and your attached article also states the same information. If you wish to better understand this aspect of PET Scans you might want to read the specific section of the article discussing it.

The addition of the radiotracers are, in this discussion and in the article, specific for prostate cancers and perform as I described, the article describes, and you mention.

The original point/question had to do with how a kidney tumor could appear on a scan intended for prostate cancer.

[Tall_Allen in reply to CoyoteGuide]

Since I wrote that article, I certainly know what I wrote. Perhaps you can cut and paste the quotes from my article that you believe adds credence to your belief that one PET radiotracer (like Ga-68-PSMA-11) can also detect prostate cancer metabolism of glucose.

[CoyoteGuide in reply to Tall_Allen]

It would be impossible to provide you with quotes for something I never stated and never stated that I believe.

Perhaps you would provide quotes where you think that I state that I believe

"... that one PET radiotracer (like Ga-68-PSMA-11) can also detect prostate cancer metabolism of glucose... "

when I state nothing like that at all.

[Tall_Allen in reply to CoyoteGuide]

That's easy:"Any PET Scan can see sugar-based 'hot spots' caused by the natural biological processes in the body. The various radioactive tracers added (PSMA, Axumin, etc.) for prostate cancer PET Scans are MORE reactivate to prostate cancers and highlight them better than just the highlight from the non-prostate PET Scans."

Can you explain that? Or do you now believe you erred when you wrote that?

[CoyoteGuide in reply to Tall_Allen]

The explanation is exactly the sameAny PET Scan can see 'sugar-based' biological activities. The prostate cancer radioactive tracers do focus on the prostate cancers. Nothing erroneous about that.

However, the prostate cancer radioactive tracers do NOT preclude false-positive prostate cancer PET Scan results because of the underlying biological processes. Personal experience based on the confirmation of two Oncologists, Urologist and Medical (from unrelated practices).

[Tall_Allen in reply to CoyoteGuide]

No - you've got that all wrong when you say "Any PET Scan can see 'sugar-based' biological activities." ONLY FDG (fluorodeoxyGLUCOSE) PET/CT scans see sugar-based biological activities. Glucose is sugar. In fact, FDG is NOT specific for prostate cancer -- it shows any cancer. And if you read my article again, you will see that it is usually very poor at detecting prostate cancer. I hope you understand better now.

I never disagreed that false positives are possible with all diagnostic tests.

[CoyoteGuide in reply to Tall_Allen]

Thank you Tall_Allen.It goes without saying that glucose is sugar.

Considering that with my false-positive Axumin PET Scan (18-F- Fluciclovine) both Oncologists (and from research into Positron Emission Tomography over the last 20 years) stated that it was because of the nature of PET Scans in general to show sugar based biological activity I will talk to them again about this perspective.

I fully understanding the specific aspects of the FDG PET Scan. Unfortunately the primary point is with Prostate specific scans and with PET Scans in general.

[NOCanceros in reply to Tall_Allen]

Hell Tall

I forgot somthing to write.

First they injected me with Galium 68 and took me after 1 hour to the PET / CT scanner when they did the scanner later on, they gave me a CONTAST medel and scanned again .

I wonder why....!

I made a connection with my Oncology Dr. he told me that was a promising result,He advised me to start Bicalutamide 150mg already i took tablett for the third day.

But he wrote the following :::: Foremost is the kidney situation, that has to be resolved.

what does he mean Tall to be resolved , By the way i will ask him later.

Thanks for Tall_allen and any member of this good blog and thanks for the administrator .

In our situation advanced cancer patients ,is it good to take vaccin against covid 19 or not. I never took vaccin.

George

[Tall_Allen in reply to NOCanceros]

Yes, of course get vaccinated!

The contrast helps the CT show up better.

It means your kidney problem is more urgent, so they have to fix it.

[Cooolone]

How a Kidney tumor could appear on a scan intended for Prostate Cancer?

Ummmm, you are aware that the metastatic tumor may in fact be Prostate Cancer that has traveled, attached and grown on the distant organ? Doesn't matter where the cancer lands, it does no then become "kidney" cancer... Or bone cancer, brain cancer... It remains defined by it's origin and tissue samples will confirm that. But as noted, especially with a G68-PSMA-PET scan, the contrast of which specifically attached to protein only secreted by prostate cancer cells, this is only going to show PCa. As for hotspots and scan readings... Well that's only as good as the viewer looking at them in regard to missed signals or diagnosis. It happens!

Best Regards