hello
My dads psa increased the last few times it’s now at .60 so the oncologist wants to do a CT scan and then I guess if it shows anything he will change meds- he has had two pet scans prior about a year and then two years ago which were good. But now the pSA is slowly rising - Is this CT Scan common, and what would it show? and if he does end up going off Zytiga and dexamethasone is there still Lots of tx available that can put this back in remission? I’m Just worried.
Why don't they order a PSMA PET/CT?
I am unsure
A CT scan most probably will not show anything wth a PSA 0.6. Discuss doing a PSMA PET scan which has a detection rate around 65% when the PSA is 0.6.Perhaps he ordered the CT scan because if it does not show anything he qualifies for darolutamide for non metastatic CRPC.
Good point with Nubequa (Darolutamide).
He has stage 4 in bones
Are there still lots of tx available when it’s stage 4 and Zytiga stops working
Yes. He should request provenge a vaccine wich could prolong survival.
He could have chemo with cabazitaxel, or treatment with LU 177 PSMA. Both are systemic treatments and have similar OS.
After any of those treatments he could try enzalutamide or apalutamide or Xofigo.
There are multiple trials with protacs, immunological trials with CAR T cells, BITE compunds etc.. and drugs combinations.
Thank you I thinkHe may be thinking Xofigo. Maybe that is why CT scan? This is about my dad not myself- my dad does ask question and I also at times go along. The oncologist is very nice and he is the director of the hospital- he was also referred to us from Fox chase when we went there for a second opinion, in the beginning. I just like to post things on here to validate that we are doing things in correct direction and it helps me learn and to
Help me ask those
Important questions!
Original psa was 33 and
I think he was stage 3b -He had prostate cancer and it was regional and treated successfully for about 5 years with radiation and lupron-
Then psa started to rise while on hormone vacation after two years not on anything. the dr then did all the scans and said it spread to ribs and spine- did MRI and everything too- had Axumin petscan two
Years when it came
Back along with MRI on spine- so they tried Zytiga prednisone and lupron and was good for two years then when started to rise tried to switch to dexamethasone- but recently it continued to rise between .30, .43, .60 now
On Zytiga dexamethasone also along with lupron and Xgeva!
If PSA is going up when on ADT and zytiga, the cancer is mCRPC.
When a drug like zytiga fails it seems better to continue treatment with chemo or Lu 177 PSMA.
The new anti androgens, Abiraterone, enzalutamide etc.. have crossed resistance.
He should request Provenge and a biopsy if possible.
This is from your post from a year ago:
"eeGee1 year ago
Prior to my prostate removal on 4/6/21 my PSA was 111, and the abominal/pelvic area and full body CT scans showed no progression beyond the prostate. My Surgeon waited three months to recheck my PSA which was then 268! We then did an Axium PET scan and found numerous areas of cancerous lesions. It's therefore been my own and other's experience that the CT scans are virtually worthless. If you really want to see the true picture, you need to get a PET scan."
He had Axumin pet scan in past already
It would be nice if you could find some time to fill out your profile information.
It could help to others to provide a better information. It is very frustrating not to be able to answer properly your question.
Can you communicate with your oncologist, he must have all the information in front of him unlike us.
If you can't communicate with your oncologist be best would be to find a new one. Nobody is irreplaceable.
I understand that it is not preferable to change doctors, but maybe you could get a second opinion from someone else?
I get a CT scan every 6 months. Blood work for me is every 3 months.I am scheduled for my scan and blood work the end of this month.I am metastatic to my lungs. The larger nodules the CT scan sees those. My oncologists use those CT scans to verify that there is no growth.I was part of the PSMA GA-68 scan trial at UCSF. That's where my lung nodules were found. Usually they like to see a 2.0 PSA before doing a PSMAGA68 scan.
I agree about doing the GA68 PSMA PET at PSA 2. Except maybe in my situation when I am afraid of brain metastasis. I have a bone met in my neck just under my skull.
Just a note.. my lung metastasis according to my oncologist(s) are JUST as worried (or more so)about my lung mets spreading to my brain then as if I had bone mets. Soft tissue to soft tissue is what mine is/would be. If you want a PSMAGA68 you can pay for it yourself. The question is what do you derive after you get it? I'm sure you're being treated the best your oncologist can do right now.
Most of these scans can generate a fair number of false negative results at low PSA levels.
Most of them seem to minimize false negatives if you wait until you have a PSA of 2.0
Personally I wouldn't do a scan until I reached a PSA of 2.0 or higher.
If you do it before then, and you get a negative, how much confidence can you have in the results... without doing a second scan.
If you want to do a once and done, wait until your PSA reaches 2.0 to do the scan
It's always a conundrum regarding the timing of the ultra-sensitive PSMA test... Wait until it's efficacy level is assured, or take a shot early and try and find something that may be causing the PSA... But the G68-PSMA is still the most sensitive, and even 65% @ .06ng is better than anything else... But what to do, what to do? Let the little buggers (cancer cells) do their dastardly deeds unabated while waiting for it to progress to the point it can be seen?
I'm not saying or advocating either way, just highlighting another choice we must all make and how it may impact our decisions and results! This crazy rollercoaster we all ride on with a PCa diagnosis!
Best Regards
Bone scan shows tumors in bones. CT scan shows tumors in soft tissue.
Sorry to hear about your Dad . As far as i know PET SANN IS THE BEST scanner out there ! My PSA is at 40 now and i will be going for a PET scann soon . I am 67 and was operated 2002 and had my prostate removed in Toronto . My PSA came back 5 years later and keeps on goin up ever since .
I guess there is still a lot out there so that’s the good news
Here's my PSA over the 14 years since I was diagnosed with PC. I have had scans but all were negative. They can't see anything under 1/2 inch. But for your dad, at PSA .6, you shouldn't worry. because his prostate has not been removed. My PSA rose to 35 during a four-year vacation from Lupron, then upon resuming Lupron it dropped to <0.1, undetectable, for past two years."According to the American Urological Association, Serum PSA should
decrease and remain at undetectable levels after radical
prostatectomy. The AUA defines biochemical recurrence as an initial
PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory
PSA value 0.2 ng/mL or greater.
Values obtained with different assay methods or kits cannot be used
interchangeably. Results cannot be interpreted as absolute evidence
of the presence or absence of malignant disease."
You’ll get a more accurate result if psa is between 1.5 and 2.0.
Has anyone tried high dose IV vitamin C?
hello, we have tried this along with ozone eboo and some oral supplements when we found out dad had bone mets, dad reported feeling great/better/stronger, although at that time even with bone mets his psa was less then 4
Disturbing CT scan
PSMA scan results 
Bone scan/CT sensitivity?
Elgie's bone scan and CT scan
Bone CT results.
