I'm scheduled to have a PSMA test on June 6th and concerned about what it will show. What are the best and worse outcomes. I see 3 possible results.
1- Nothing shows up on the scan.
2- one single location is identified.
3- many locations are identified.
My anxiety is kicking in.
The best thing is that nothing shows up. There is not radiographic progression of the cancer and you can continue with the same therapy even when PSA may be going up.
Option 1) best, 3) worst.
If you have a PSA value of 0.3 ng/ml without ADT, the PSMA scan will probably show nothing. Better wait for 1.5 or 2.0 ng/ml.
Its so annoying isnt it? The cancer is little but we dont have anything that can kill it.
If we didn't have a ultra sensitive PSA test we will never know we had PC
Hey Old Horn….I think that the jitters hit us all while we’re waiting on test results. I usually go into panic mode too , but try to ease it by knowing that I have a very competent Oncologist taking care of me. There are a couple of guys on here, Tall Allen and Magnus64, that somehow ease a bunch of my anxiety just by reading their responses to some of my questions. This is a scary disease, but a whole lot less scary than it was even a few years ago. Lots of great research and new therapies. Best of luck, and try to ease up on the anxiety…..people can live long enjoyable lives…. even with having advanced disease. Jim
Thanks for your response. I try to stay calm and count on my MO to steer my treatment in the right direction.
I was part of the UCSF trial for the PSMA GA 68 scans. To me no matter what your results will be, the scan is one for the future. For me I know that my son's will probably be able to use it if they need it. It pinpoints virtually everything. I started with a persistent PSA right after my radical prostatectomy. I had a quick doubling from virtually nothing to 1.9 in about a year. Normal scans finding nothing. I was very fortunate that my local oncologist has a very good friend at UCSF. A world-renowned prostate oncologist. He is my oncologist now too. Two is always better than one! He got me into the trial.
To do the scan and immediately knowing where your metastasis might be is reward in itself. No second guessing here. Earlier detection means faster and earlier treatment. Doing things quicker (and earlier) now hopefully will save more lives. I honestly feel it has done that for me. I'm into my sixth year now. Where I thought maybe 5 years ago I was not going to be here in 5 years I can truly say I have a gift and that was this scan.
Good luck to you no matter what the results are. You can't fight what you can't see. This scan will allow you to see and start the fight. Being able to get this scan is a gift in itself. The gift is also earlier knowledge to fight. Good luck to you!
Thank you so much for your encouragement. I consider myself lucky having survived for 13 years since my PC surgery. For 7 of these years my PSA was undetectable until 2017 when it was 0.01. It started to increase slowly until 2021 when it reached 0.12. Unfortunately IMRT last year didn’t help and that is where I’m now at 0.19. I hope the PSMA will help us find where the cancer is
Recalculate your doubling time. If I understand your profile your psa in Sept 21 was 0.12.Currently in May 22 is 0.19. (0.12 x 2 + 0.24) You have not even doubled once since your IMRT. Keep an eye on the trend but relax and enjoy life. PTL!
My RO said that I should only use the number obtained after the end of RT. In this case I should use the following results:09 /22/2021 .12
12/24/2021 .13
03/24/2022 .19
05/06/2022 0.30
using those numbers my PSADT is 6 months. If I use the last 2 test only then PSADT is less than one month
If I read your PSA’s correctly, the last 2 tests went from 0.19 to 0.30 in about 1.5 months. If the 0.19 were to have doubled in one month, it would be 0.38 by 4/24. So, from mskcc.org/nomograms/prostat..., your DT is 2.1 months.
From conversations with my MO, I typically wait until absolute PSA value is around 1.0 give or take before bothering to calculate PSADT. At very low levels, there is more variability, and for that matter, one can have a faster DT at low absolute levels, since T is recovering more quickly at that point (assuming your T was low and PSA is rising b/c you’ve recently stopped ADT)…i.e. DT is at least partially a function of rate of T recovery, if I understand correctly.
But, sigh, I’m not a doctor, nor are my initials TA.
Thanks. Your right about doubling time it is actually 2.1 month. Just to clarify, I have not used ADT or any other drug to treat PC. In your opinion , If the PSMA PET shows nothing and the PSA is still low should I start ADT anyway?
This is really a question for your MO — I’m not anywhere near qualified to offer advice. I wish you the best with this.
I am in your situation exactly except for doubling time. My PSMA scan has a couple of questionable boney lesions that turned out to be falsely positive. If your scan is negative you can get radiation therapy together with anti-testosterone therapy and get a significant chance for cure. If it is positive outside the pelvis the chance for cure drops but you can still have many years of great life ahead. My brother and I both have this disease. We favor denial whenever possible. The focus should be upon enjoying each day to the max.
Maybe cross that bridge when/if you reach it.
Mine showed 8 abdominal cancer metastases and so far they are well controlled with Erleada/Lupronb and life goes on, so my answer would be no lesions as a best view
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