Hi, I have a question regarding my dad’s latest PSMA scan , it seems the scan has not found new metastasis and the old mets seems stable!
My dad’s psa was around 0.04 and I’m wondering if the scan was useless.
is it possible that there are mets but the scan did not catch them since the psa is so low? And are there mets that don’t express psma and if so what other scans do you recommend?
PSMA PET scans won't show anything in men with such low PSA. There are no scans that are useful. Why are you trying to use a scan to find metastases?
He had no scan since 2020 , and he started his vacation few months ago , I was worried for him so I suggested a new scan to compare with the earlier ones, since he is stage 4 and on vacation, I was so worried for him but now I think maybe it was useless and still can’t get some relief from overthinking, so what do you suggest?
I’m surprised your MO ordered such a scan. Did you ask him why with such low PSA?
So, I infer that you are trying to decide when is the best time to end his ADT vacation? There are no guidelines. He is taking the vacation presumably because the side effects of ADT are onerous. So he will want to have some time with normal testosterone - he should monitor that every 3 months along with his PSA. Most end vacations when PSA reaches 2 or 4, although some wait for 10. I don't think that scans are very useful for this purpose.
I get a few prostate cancer stage 4 update emails, I read through and all give me a great insight and realistic view of what I'm living with and how it can effect us.But when ever I read your tall Allen replays,
They are very concise, practical, they seem to make sense in a mine feild of terminology and wordy words....
So just a thank you from me to you for all your posts I've ambled across.
And for the site.
And every one else posting questions and answering questions.
Really can make a dark grim day open up into a good straight up day.
Tall Allen, I am at 0.51. Is it you opinion that I should wait until 2.0 to resume ADT? My T pre-PC was 700 and now 220. BTW
That is a call only you can make. The only reason for the vacation is to give you a break.
I had RP, EBT & started Lupron for 2.5 yrs.
Maintained <0.1 PSA. Went off Lupron & after 1.5 yrs. (T rose to 240). 1 mon. later PSA rose to 0.4. Axumin Scan showed lesion, only on T-ll. Considered Oligomestatic. Had it Radiated.
3 mons. later (T rose to 330), PSA shot to 7.3, mets through out skeleton, big one
trying to get to spinal cord on T-4. Went back on Lupron & added Apalutamide & Xgeva.
After 4 mon. PSA 0.2, T down to 12. Will have PSA & T tested per mon. until remains
stable & then every 3 mon.
I am a GS 9 (4+5), so my cancer may be more aggressive, but I would advise
you to be very cautious.
I wish I had stayed on Lupron because my SE's were minimal, except my wife thought
I was getting more "grumpy". Any time I want to make her feel bad, I remind her of this!
On that last sentence, did you mean "with such low PSA?" Since how else would one find Mets other than with scans? Just a clarification. Thanks
You don't typically find metastases when you have low PSA