The journey continues. I have been in a battle with the PC Beast for 20 years. Had RP, Radiation, and Chemo. All worked for a while. I just received my 3rd injection of Radium 223. My PSA is still 9 but my ALP has dropped from 178 to 58 which seems very encouraging.
My MO at Phoenix Mayo just asked me to have a PSMA Pet Scan versus my normal Bone scan and CT scan. My mets are only in my bones. What should I expect from the PSMA scan??? I know it is new. Any experience or opinions would be very helpful.
Thank you so much for your input. We all fight the bast together.
I had a PSMA scan a couple of weeks ago. It was pretty painless. They injected the tracer into me and I waited for 90 min. I also drank a bottle of the solution that’s used for the CT contrast. The scan is like a long CT scan, about 30 min. Just lay there not moving as you’re slid through the tube. I almost fell asleep. The worst part was that my arms were raised above my head throughout. After 30 min they were rather stiff but back to normal quickly. No after effects.
It lights up the areas of PCa quite nicely. The PSMA scan is prostate specific so it what is lit up is almost certainly PCa. Whereas the bone/CT scans are not prostate specific so they just show abnormalities that could be caused by a variety of problems, like arthritis. Other information like PSA levels have to be used to determine if what flagged is really PCa. And the PSMA scan can pick up much smaller amounts of cancer than either the bone or CT scans.
I was wondering the same. It's my understanding that you need to wait a year to be able to use Pluvicto after xofigo. Our MO wasn't sure of the wait time between treatments or if at all. Could it have been ordered to get a better picture?
My brother had his 6th Xofigo in January and had a PSMA scan April 1. I have not seen anything stating it was necessary to wait a year. Do you have the reference to that? Curious; if that is true, we have made treatment decisions based on that scan.
Our MO mentioned a year wait time between Xofigo and Lu177 at our last appointment. I would like to see something definitive on this also. I'd hate to think we're all just guessing. What is the wait time for your brother's treatment?
There was no wait time mentioned. He was having a lot of back pain, and the bone scan didn’t show anything. The PSMA scan showed a lesion in the area of his pain, so he had palliative radiation which resolved the pain.
I saved a post from 12 months ago "Lu-177 switch from Xofigo. How long an interval?" posted by baltha. Nalakrats replied by doing the math on this - which makes good sense and is good knowledge to have. It will be helpful for us on our next appointment. His reasoning says 3 months wait time. It didn't occur to me at our last appointment to ask why the year wait. He made a comment about "if at all". This may apply to us personally. Of course there will be guidelines from the drug manufacturer that may dictate a different wait time and probably insurance hoops to jump through. These questions are added to my list. Best of luck on your treatments and your brother's. And may God bless us all and guide us through all these tough decisions.
Bone scan showed nothing. He was having lots of back pain in the sacral area. His MO wanted to send him for a steroid injection. I suggested he hadn’t had a PET in quite some time, (18 months) and I was highly suspicious it was cancer, not orthopedic. The PET showed widespread intensely avid osseous metastases including a sacral lesion with SUV max of 35.5.
Great fight - congrats! PSMA PET is the best you can get and will provide a much better picture compared to CT and bone scan. I‘ve had three already, no side effects so far.
Hi, have just had my fifth combined PSMA/CT scan (in Australia) and all have been without after effects. Typically a 15 minute walk and 30 minute drive afterwards. Got a false positive at PSA<0.2 but otherwise invaluable for treatment planning.
I've had this scan. Other than the fact you have to wait around for an hour for the radioactive water to penetrate your bones, it's an easy one. It lights up all your bone mets like a Christmas tree. You can find pictures in Google images. I was never given a copy of my own. I understand the scan is considered somewhat "experimental" but viewed in conjunction with other scans, it gives your consultant a lot of detailed information.
Hi, I have had 6 PSMA scans..three here in the states and three in Delhi.. Also Lu-177. If you are PSMA avid it will show areas of concern much earlier than anything currently out there. My current PSA is 0.16 and has doubled in the last 9 months ..We retest with blood work in July and a new scan in September . Just think of it as another scan with contrast...Early detection with new paradigms of treatment give us some edge for a change...Blue Skies
Lutetium works best when it is used early. This argues against waiting until failure of all other treatments. The wait time between Ra223 relates to bone marrow suppression. If your blood counts are OK you probably don't need to wait. Lu-PSMA-617 has low marrow toxicity anyway. If your PSMA scan shows avid lesions (lights up cancer sites), then you should really think about pursuing treatment promptly, in my opinion. Since Novartis cannot reliably source Pluvicto, you might need to go abroad (Germany, India, Australia and others) in order to get timely treatments. It is your decision and it has consequences. Good luck.
PS: I just finished my Lutetium treatments in Australia today. Paul
Time will tell, Tom. I just had the second dose yesterday. It has a 6.6 day half life and is slowly excreted through the bile. So it will be working to kill cancer for the next 2-3 weeks. I am staying on my high dose testosterone as advised through the next two weeks. Then will drop that and go on a 4-6 week low T cycle with Orgovix. PSA levels will then give some measure of the effects, especially after the Testosterone levels go high once again with SRT.
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