A List of Screening Tests For A High PSA

[Dd7757]

A 73 year old friend had a PSA test that came back @ 50 . He is not afraid, is cool and analytical. He can afford to have any out of pocket testing and treatment . He wants to understand the status of his prostate cancer before having any treatment. He is asking if there is a list of screening tests that he can take that will give him the most comprehensive overview of his cancer. I told him I am not aware of a specific list.

However, there are many wise people on this site who could .

My list, which may be incomplete or duplicative, is:

(1). A Saturation Biopsy.

(2). A PSMA - PET - CT scan.

(3) A Sodium Fluoride Bone Scan.

(4). A Guardant 360 Liquid Blood Test.

Any additions or deletions will be appreciated.

[Tall_Allen]

He has to do this methodically - random tests are inappropriate.

Negative DRE? Does he have any urinary issues? If not, his first step is a bone scan/CT.

If bone scan/CT is positive for distant metastases, he can pursue therapies for mHSPC.

If bone scan/CT is negative, he can get a PSMA PET scan. If PSMA is positive for distant metastases, he can pursue therapies for mHSPC. If negative, he should have a prostate biopsy (transperineal if he can find a urologist who does it). Etc.

One step at a time.

[Hidden]

I know a guy told me his was 56 and turned out to be BPH or an infection or something. What he said anyway

[Justfor_]

3T multiparametric MRI to start with and PSMA PET/CT to follow. A competent reader of both imagings in comparison is key.