My PSMA-Pet Results

[bglendi53]

So I finally got my PSMA-Pet ( 18F-DCFPyL-PSMA ) scan and I have quite the array of lumination. I have no idea what the SUV numbers mean or represent, they all look quite high to me. My RO says he could do 5 consecutive days of radiation and there should be at least a 70% chance of be successful at eliminating the pain. Problem is, I don't have that much pain, so I don't know what to do at this point. If anyone can chime in that has went through making this decision I would appreciate it.

It certainly found areas I didn't know I had affected.

[tango65]

The SUV values indicate the cancer has a lot of PSMA. I think treatment with LU 177 PSMA will work well and treat the cancer everywhere.

[Tall_Allen]

I trust you are taking Zometa or Xgeva. You can re-do Xofigo, and add docetaxel this time at a reduced dose. Perhaps add Provenge too.

Alternately, there are a few clinical trials now of 177Lu-PSMA in chemo-naive patients:

prostatecancer.news/2020/08...

[bglendi53 in reply to Tall_Allen]

I'm actually on Zytiga as of July 1st. I was on Xofigo for only three months. Since July 1st my PSA has dropped from around 40 to 24. That's my first drop since March of 2021. My MO mentioned my next step might be Chemo, but he didn't elaborate. I'm going to be asking him about 177Lu next month.

[Tall_Allen in reply to bglendi53]

Did you mean Zometa? Why only 3 months of Xofigo?

[Seasid in reply to Tall_Allen]

Good question.

[bglendi53 in reply to Tall_Allen]

Wasn't sure if I replied in the right spot so here were my remarks. When I visited my MO the first week of June he told me I "looked more beat up". He didn't feel the Xofigo was working so he canceled my 4th injection scheduled for that same day, and took me Erleada at the same time, and set me up to start Zytiga. My PSA had been rising for about 16 straight months and was upto 33 on June 9th.

[Tall_Allen in reply to bglendi53]

I don't know what "beat up" means - was your bone marrow suppressed?

[bglendi53 in reply to Tall_Allen]

That was never mentioned

[Seasid in reply to bglendi53]

Would ask him why did he cancel your therapy.

[Seasid in reply to bglendi53]

you can only have 6 Lutetium infusions in your lifetime. 6 Xofigo infusions could be repeated if needed for paliation of bone pain

[bglendi53]

Well when I visited my MO the first week of June he told me I "looked more beat up". He didn't feel the Xofigo was working so he canceled my 4th injection scheduled for that same day, and took me Erleada at the same time, and set me up to start Zytiga. My PSA had been rising for about 16 straight months and was upto 33 on June 9th.

[Farmhand]

I was just reading reports about how sometimes response to therapy can be confusing when using PSMA scan… After starting Zytiga or other ADT, Even though response to therapy is good(PSA decrease), the ADT accentuates PSMA uptake and so it appears as though cancer is progressing even though the opposite is occurring. Could this be the case in your case?

[bglendi53 in reply to Farmhand]

I've only been on Zytiga for not quite 2 months, and I have another round of blood work including a PSA reading on Sept 9th. So I'll try post any important results here after the 9th

[Farmhand in reply to bglendi53]

According to this article, Zytiga intensifies the PSMA scan results after the initial 4 to 6 weeks of starting Zytiga primarily

[Farmhand]

Here is the link to the Springer article on PSMA Scan results and ADT:rdcu.be/cUci5

[nobaday]

GET LU177 however you can and before Mets eat too much bone or push on spine. I waited too long and had to have 2 major surgeries at T9 and C3.

[bglendi53 in reply to nobaday]

i don't really have any pain there now. Are those SUVs I posted similar to yours?

[Seasid in reply to bglendi53]

your SUV max values are very high

can you change oncologist?

first he took you off Xofigo than he transferred you from Erleada to Zytiga plus Prednisone. All of this doesn't make sense to me.

did you have a liquid biopsy? You could get Olaparib or Keytruda if you have actionable mutations.