3rd PSMA scan tomorrow

[konichiwa12]

After starting Zytiga late November 2019 then having SABR late September 2020 I am back for my 3rd Gallium 68 PSMA scan on Harley Street tomorrow. My PSA has gone from 0.54 > 0.614 > 0.793 > 0.879 > 1.43 after 4 weekly tests. Quite a big jump on the last result indicating increasing "activity" somewhere! I hope it's not in my right Ilium again as that can't be radiated any more! The doubling rate is just over 2 months and getting less. I suppose it is a case of just wait and see what the results are but I have had some very low moments after quite enjoying life for a while now!

[StayPositive1]

Good luck with the scan konichiwa

[Tall_Allen]

Let us know what the scan tells you.

[konichiwa12 in reply to Tall_Allen]

Hello TA. Did you see the scan results I posted? I am interested in your opinion please?

[Tall_Allen in reply to konichiwa12]

Where would I have seen that? I have no PMs from you.

[konichiwa12 in reply to Tall_Allen]

I am sorry but I thought you had visibility of this from my post:The new abnormalities are:Pelvic bones and lymph nodes

Left sacrum uptake

L4 vertebrae

RH Ilium

Prostate gland

RH Pelvis at back of abdomen.

Docetaxyl to start 10 sessions every 3 weeks. I have had the important conversation with my son.

I'm not sure if there is anything anyone can say to help?

I kind of knew this was coming.....

[Tall_Allen in reply to konichiwa12]

I only read original posts and replies directed to me because they land in my inbox. I generally don't read others' replies or replies to others. It would take all day.

Docetaxel is a good next step. You must be in good shape if they are planning 10 sessions - it's usually 6 to give the patient a break. There are usually scans done after a few to see if it's working. Neulasta should be required during the pandemic, imo.

What is RH? I don't know what "RH Pelvis at back of abdomen" means.

[konichiwa12 in reply to Tall_Allen]

Right Hand I think! Thank you so very much for your time to assess my condition!

[Tall_Allen in reply to konichiwa12]

I don't think that's what it means. They write "left sacrum" not LH sacrum. Also pelvis is below the abdomen, not "at back of." Is it a translation from another language?

[konichiwa12 in reply to Tall_Allen]

I hope yhis has the full detail of the report. I'm sorry my IQ is only 127 so I don't understand this.

.

[Tall_Allen in reply to konichiwa12]

Way too small for these old eyes, but I don't think anything there makes a difference to your next treatment.

[konichiwa12 in reply to Tall_Allen]

There is persistent GA-68 PSMA avidity in the prostate gland extending into the right seminal vesicle. The extension into the seminal vesicle seems more today than previously. There is a new small avid proximal right common iliac node SUVmax 30.5. There are multiple small distal paraaortic n aorto caval nodes e.g. posterior aorto caval node in front of L3/L4 disc space SUVmax 9.3. There are no further GA-68 PSMA avid retroperitoneal lymph nodes.

The hepatic distribution of GA-68 PSMA is unremarkable.

There are no GA-68 PSMA avid lung nodules. There are no GA-68 PSMA avid hilar or avid mediastinal lymph nodes. Small new avid node left of the left Thyroid SUVmax 4.4.

There is a new intensely avid L4 vertebral body lesion.There is a new avid small lesion in the left sacrum, adjacent to the upper left SIJ. Right iliac mestasis SUVmax 108 today, previously 150. There are no other GA-68 PSMA avid skeletal deposits. The distribution of GA-68 PSMA elsewhere is physiological.

Conclusion

New GA-PSMA avid nodal and bone metastases in keeping with disease progression.

[Tall_Allen in reply to konichiwa12]

Hopefully, docetaxel will shrink those. If any of those spine/hip metastases are painful, they can zap them with SBRT.

[konichiwa12 in reply to Tall_Allen]

The RH Iliac has already has 5 SABR zaps so that can't be done again.

[Tall_Allen in reply to konichiwa12]

Bone metastases can take quite a lot of radiation, and often can be retreated if they grow back and become painful.

[CAMPSOUPS in reply to Tall_Allen]

That's good news to me. I was misled or misunderstood way back 2 years ago when I was dx'd that I should save "bone zapping" for when it is quite bad because it could only be done once.Maybe I can do the 3 or 4 nuisance pain bone places now vs. later and enjoy life more.

[Tall_Allen in reply to CAMPSOUPS]

"In everyday clinical practice, retreatment for painful bone metastases leads to pain reduction in 66% of evaluable patients and 43% of patients in a worst-case analysis. Patients who responded to initial radiotherapy were more likely to respond again and those on systemic therapy were less likely to respond. Overall, repeat radiotherapy should be considered in patients with persisting bone pain."

clinicaloncologyonline.net/...

[CAMPSOUPS in reply to Tall_Allen]

Excellent. Thanks as always!

[CAMPSOUPS in reply to Tall_Allen]

LH, RH. A car mechanic or engineer who became a radiologist lol.

[konichiwa12 in reply to CAMPSOUPS]

Excuse me?

[CAMPSOUPS in reply to konichiwa12]

Sorry I hope I didn't offend by trying to be funny.In my work with printing presses parts and so forth are often described by the engineering drawings as LH (left hand) RH (right hand) side etc.

Also cars. Left hand drive, right hand drive. I thought the LH,RH notations were odd in a medical report as I was also in the medical field 40 plus years ago.

Also I really wanted to but didn't get to it. I wanted to let you know you should be alright. I felt sorry for you in that you said "you had the talk with your son". If I remember you are younger than me so your son might be somewhat young also. It must have been a tough thing to do.

My son is in his early 40's and when I told him he was as has been the case for years now--he was the adult in the room. He said he expected something like my diagnosis to happen someday.

The tears though came when he and my wife came to my first Oncologist appointment and we got more particulars on my diagnosis.

I believe strongly in the effects of chemo and pray you will respond as so many do. You and I both should have many, many years ahead of us and the longer we stick it out the more new treatments come along.

[konichiwa12 in reply to CAMPSOUPS]

No problem, I’m an automotive engineer so I am also very familiar with that teeminology! 😀

[CAMPSOUPS in reply to konichiwa12]

⚙️ 🔩🔧

[konichiwa12 in reply to CAMPSOUPS]

Terminology!!!!

[MateoBeach]

If it lights up it may be time to consider Lu177 +/- Ac225 treatments. May need to travel abroad from USA with FDA dragging on and silent.

[konichiwa12 in reply to MateoBeach]

If it "lights up" I think Chemo will be the first recommendation....... I live in England so Lu177 is available here anyway I believe?

[j-o-h-n]

Good Prayers for you...........

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/20/2022 11:22 PM EST

[lcfcpolo]

Hi. Good luck with the scan. England here as well. I'm not aware LU177 is available on the NHS and am unsure if AC225 is available at all in the UK. If it is only available privately, it might be cheaper to visit Germany, Baku or India, where practitioners have more experience as well. Tc.

[konichiwa12 in reply to lcfcpolo]

I have private health care as I work for Nissan up in the North East. I presume I would not get PSMA scans at the Harley Street Clinic otherwise on NHS? I feel slightly guilty for some reason? 😬

[lcfcpolo in reply to konichiwa12]

No need to feel guilty. Good luck. If you manage to find any positives from being private e.g., treatments offered and where offered, then do please share. Thanks

[konichiwa12]

The new abnormalities are:Pelvic bones and lymph nodes

Left sacrum uptake

L4 vertebrae

RH Ilium

Prostate gland

RH Pelvis at back of abdomen.

Docetaxyl to start 10 sessions every 3 weeks. I have had the important conversation with my son.

I'm not sure if there is anything anyone can say to help?

I kind of knew this was coming.....