Need Info on latest PSMA scans/locations

[compiler]

I was dx. with PC in Dec. 2009. Failed surgery and SRT. Have done well with HT (numerous lengthy HT vacations). Anyway, fast forwarding:

A few years ago I had this scan as my PSA was rising. They found 2 spots (lower iliac nodes). They did SBRT, 10 sessions (those nodes and very nearby). It did wonders, knocking my PSA from 7.8 to below 0.21. That was in Jan, 2019. My PSA has been bouncing around between 0.21 and 0.75. It is now 0.47. My next PSA will be late January, so basically 3 years after my SBRT. If it rises some more, depending on the amount, I might opt for a Ga68 PSMA scan or maybe the newer PSMA scan. We now get to my question.

I no longer see the PSMA scan on the Umich site. I vaguely recall reading that it is only given at UCLA and in SF. Is that true (it was in clinical trials when I had it at Umich and now I think the trials are over and the FDA approved it). So, where do I get one of those 2 PSMA tests. I know the newer one is preferred because the tracer has a longer half-life and hence it can be done at more places. Is the newer one better in terms of results?

Bottom line: where can I get the PSMA test in Michigan. Due to a spinal injury, it is hard for me to travel (not to mention Covid concerns and flying).

Mel

[tango65]

Many places are doing the “new” PSMA PET/CT , know as Pylarify or 18F DCFPyl PET/CT. IT is similar to the Ga 68 PSMA and it may have a better detection rate at low PSA like in your situation. Call the different Medical centers in your area to find out if they offer this scan. Medicare pays for PSMA scans now.

[Tall_Allen]

Call pylarify 1-800-964-0446 to find a site near you.

As you know, I think it was a mistake to treat only the most visible pelvic lymph nodes:

prostatecancer.news/2020/12...

I hope that a good RO will be able to work around your previous two radiation sites to provide full pelvic coverage (assuming, of course, that it is still confined to the pelvic LN area).

[compiler in reply to Tall_Allen]

Tall:

I said:

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They did SBRT, 10 sessions (those nodes and very nearby). It did wonders, knocking my PSA from 7.8 to below 0.21

>>>>>>>>>>>>>>>>>>>>>>>>>>>

So I know he did the suspect nodes and more. It finally slowed the PSA velocity.

Thanks for the info.

I have a call in to Umich to see what they have.

Mel

I

[Tall_Allen in reply to compiler]

Treating the known LNs and a small area around it, is NOT the same as treating the entire pelvic LN field. In fact, the pelvic lymph node treatment area has been expanded to include the common iliac LNs. One has to treat the entire pelvic L N drainage area, otherwise cancer will escape to other areas..

redjournal.org/article/S036...

You are also making the mistake of using PSA as your indicator that the treatment worked. This is a common misunderstanding among patients and doctors. Most of the serum PSA comes from the larger loci of cancer - the sites large enough to have generated their own leaky blood supply. This is called "treating PSA" instead of treating the cancer. Please read this:

prostatecancer.news/2020/07...

[Concerned-wife]

Here are the current and currently planned locations for Pylarify PSMA scans

pylarify.com/ordering-and-r...

[compiler]

Based on the web-site there is no site in Michigan, nor is one planned. I will still call. According to Umich site, they do PSMA scan and use:

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[18F]fluorodeoxyglucose (FDG), a radioactive sugar molecule that can be used to identify tumors and diagnose cancer:

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Does anyone know anything about this tracer?

Is this outdated, or is PSMA still key?

Mel