PSADT is 6 months

[old64horn]

My PSA increased from 0.19 to 0.3 in just 6 weeks. My MO is scheduling a PSMA pet to see if the cancer is localized or metastatic. I will most likely start ADT or ADT+. Recommendation are welcomed.

[tango65]

I would wait for radiologic evidence of progression of the cancer to decide further treatment.

[old64horn in reply to tango65]

Thank tango65, I think that is what my MO will decide.

[6357axbz]

Get the PSMA scan. It’s a no brainer

[old64horn]

Thanks for all your responses. That is what my MO is planning to do.

[old64horn]

I plan on getting one. My MO is working with the insurance company in trying ti schedule one. Fortunately there is one place in Austin Texas where I live that does it

[PGDuan]

Yes, definitely suggest you go for the PSMA PET. I had a free R&D trial scan when PSA was around 0.35 and nothing was detected but then again at around 0.7 it found the probable source which may help clarify treatment plans. Also keep getting your PSA test on schedule so you get more info on the doubling rate which can also be helpful. Best of luck!

[old64horn in reply to PGDuan]

That is the plan. I’m waiting on insurance approval and schedule. Thanks

[old64horn in reply to PGDuan]

Thank you, I’m hoping to get the PSMA approved. I have United healthcare Medicare advantage PPO. My MO believes that it will be approved even at the 0.30 PSA level since it is increasing rapidly.

[Deadstick]

They wouldn't do my PSMA scan until my PSA hit .6.

[jfoesq in reply to Deadstick]

FYI- Every case history is different, but my ins co (Oxford Liberty) just approved a PSMA for me, after initially denying coverage for it following a "peer-to-peer" with my MO. My PSA was only at .22 but had more than doubled within 3 months.

[Justfor_]

Was your latest PSA value of 0.3 (reported to two decimal digits, i.e. 0.30) or it originates from a different lab reporting to a single decimal digit? In either case, the PSMA PET is the right diagnostic next step but I wouldn't take seriously any PSADT assessment based on these two numbers.

[old64horn in reply to Justfor_]

It was reported as a single digit after the decimal point. Thanks

[Dsmejkal88]

I hope it’s localized, my dad went from undetectable to 1.4 in 4 months. His scans revealed several spots contained to the pelvis. He just started radiation for the next 8 weeks, Lupron, xtiga and prednisone. Hoping you have better or similar results.

[old64horn in reply to Dsmejkal88]

Thank you, I have already done the radiation so hopefully we can find where the cancer is

[barrybayarea]

My PSA started rising similarly 4 months ago. I have also had several rounds of radiation and it was going down but then ADT failed. I have had a PSMA scan twice, and both times it showed way more than normal bone and CT Scans combined, they showed almost nothing. To give a comparison, my last 3 CT scans combined showed 2 "possible" spots, while the PSMA scan showed 8 spots in my bones. I start chemo today. It a great diagnostic tool, best of luck!

[old64horn in reply to barrybayarea]

Thanks. What was you PSA when you had the PSMA pet

[barrybayarea]

It was 3.2 the first time and 3.18 the second time. All details are in my profile.

[Graham49]

This is similar to me. At PSA of 0.6 an infected lymph node was found with PSMA PET. This has now been irradiated using SBRT and I am awaiting PSA result at end of month.

[old64horn in reply to Graham49]

what is the likelihood that the PSMA shows an infected node even though I had IMRT to the prostate bed and the lymph nodes? I don't know how how many nodes were radiated.

[Justfor_ in reply to old64horn]

There are nodes within the irradiated field and distant ones. I have seen various papers talling the detection rate for the less than 0.5 PSA ranging from 30% to 68%. Very but very grossely one third of them are local, the other third is distant and a bit less to bones or organs. This may give you a very broad idea of what to expect.

[old64horn in reply to Justfor_]

Thank you. Hopefully the PSAM pet will show where the cancer is.

[Justfor_ in reply to old64horn]

And if it doesn't this is a good thing under the light that it is too small to be detected, hence at an earlier stage.

[old64horn in reply to Justfor_]

Thanks, let us hope that is the case