Pet Scan and Guidance

[Gatodd]

I was diagnosed with Gleason 8, cribriform morphology and PNI. Ct scan and bone scan were clean. My Decipher score is .79. My pathology report was reread and scored at Hopkins. At diagnosis, I asked for PET scan, but local urologist did not think it would get approved.

I have started aggressive treatment, ADT + Zytiga in December, HDR in February, and will complete 28 IMRT treatments in early April (11 completed as of today).

I understand from earlier post on this forum that PET scans may have been approved for Gleason 8. Should I request? Or would it just be additional information that wouldn’t change current treatment? Of course, I love data, but data that won’t change decision making seems to be of little value.

Appreciate your thoughts.

Also, the plan is for ADT for 24 months (although MO indicated he may recommend 24 months beyond IMRT, so 27 months). I am not on the Predict Rt trial, but this seems consistent. Anything else I should consider?

[Tall_Allen]

A PET scan at this point won't show anything. PSMA PET scans are PSA-dependent, so with the hormonal therapies you've been taking, your PSA is probably too low for too long.

A recent study found that optimal ADT duration is 12 months for brachy boost therapy. I think that is especially true for you because you are also taking abiraterone. You are right that PREDICT uses 24 months (with Erleada) but I think they expect most patients will only have external beam therapy. Worth discussing with your MO:

prostatecancer.news/2022/01...