PSMA PET scan: I've had a proctectomy... - Advanced Prostate...

Advanced Prostate Cancer

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PSMA PET scan

baseball29 profile image
28 Replies

I've had a proctectomy in 2019, 6 months Eligard and 35 radiation treatments in 2020. PSA was undetectable for 1-1/2 years until Feb., 2022. My PSA is now .31. My Oncologist retired for health reasons in June, 2022. I've been floundering in finding an oncologist until last week. A oncologist I wanted to see accepted me, so I see him in 3-1/2 weeks.

I had gone to a general oncologist a month ago who wanted me to start Eligard, Zytega and prednisone. I requested a PSMA PET scan.

I'm now considering canceling Eligard shot Wed., and PSMA PET scan Thursday.

What are your thoughts? Eligard too close to PSMA PET scan? Don't want to go to new oncologist with doing things. Maybe he will have a plan of his own?

Thank you.

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baseball29 profile image
baseball29
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28 Replies
tango65 profile image
tango65

If your PSA took 6 months to get to 0.3, you could wait 3 weeks more and plan your treatment with the new MO. You could have the PSMA PET/CT done before the appointment.

baseball29 profile image
baseball29 in reply totango65

I am luck to get in with this top Oncologist in Las Vegas. There aren’t too many here. I was thinking since it’s only 3 weeks until my appointment, should I let him give me his plan? Your thoughts?

tango65 profile image
tango65 in reply tobaseball29

I would get the PSMA scan and wait for the appointment with the new MO.

The PSMA scan could help to guide the therapy.

If there were bone mets you will need a systemic treatment.

If there were lymph nodes in the pelvis in areas which were not irradiated or low peri aortic lymph nodes they could be irradiatefd if there were 3 or 4.

It may not prolong life but you could delay the start of ADT.

If they do not see anything in the scan you could wait until the PSA is around 1 and repeat the study.

cesces profile image
cesces in reply totango65

I agree.

And even at 0.31 PSA all those scans have much higher false negatives than if you wait until a 2.0 PSA.

Measure twice, cut once

Tall_Allen profile image
Tall_Allen

The Eligard shot on Wednesday will not affect the PET scan on Thursday - don't cancel either. It is unlikely your new oncologist will do anything differently.

baseball29 profile image
baseball29 in reply toTall_Allen

So true, but I was maybe over thinking things. I was thinking since I see him in 3 weeks, maybe I should let him give me his plan. Your thoughts?

Tall_Allen profile image
Tall_Allen in reply tobaseball29

I just said what I think.

baseball29 profile image
baseball29 in reply toTall_Allen

Thank you!

cesces profile image
cesces

What is the doubling time of your PSA?

baseball29 profile image
baseball29 in reply tocesces

PSA was .08 in February, .17 in May, & .31 in August

cesces profile image
cesces in reply tobaseball29

Hmmm 3 month doubling time, though interestingly the doubling time doesn't appear to be accelerating... yet.

E2-Guy profile image
E2-Guy

I strongly recommend that you give tE2 gel a try. It has been working wonders for me for 4 1/2 years now. I can send you some if you can't find it in America.

dhccpa profile image
dhccpa in reply toE2-Guy

Can that be used along with Lupron? Thanks

E2-Guy profile image
E2-Guy in reply todhccpa

It is used in place of Lupron without the side effects. No doctor visits and less than $30/month.

dhccpa profile image
dhccpa in reply toE2-Guy

Thanks, I should have clarified. I meant for bone health and to minimize side effects, not for Lupron's key function. I thought I had seen some post that.

I forgot you use instead of Lupron. What's your dosage? And how do you measure?

E2-Guy profile image
E2-Guy in reply todhccpa

Its key function is to hormonally castrate while maintaining bone health. Its ONLY side effect is some degree of gynecomastia. All of your questions should be addressed in my trimonthly updates. I would never subject myself to the Lupron sh*t! Haven't seen a doctor since I started using it over 4 years ago.

dhccpa profile image
dhccpa in reply toE2-Guy

Thanks again. I'll look through your past entries.

VHRguy profile image
VHRguy in reply todhccpa

Whether or not you use Lupron, with your recurrence I suspect you may be on extended ADT one way or another.

Estradiol at a sufficient level to give a blood E2 (estradiol) level of at least 50-60 pg/mL should be enough to prevent loss of bone density, and to minimize the other unpleasant side effects of not having testosterone.

Yes, gyno is a risk. That can either just be accepted, you can try to prevent it by taking tamoxifen (blocks E2 in breast tissue), or even possibly some radiation to the breast area to prevent growth. I elected to simply tolerate it, and yes I do have some.

I'm on transdermal patches, and I feel fine. (No sex life, but I don't care. That comes with a complete lack of testosterone, for which I chose the surgical route.) But, do your own research, talk to your doctors, do what you find to be right for you.

dhccpa profile image
dhccpa in reply toVHRguy

Thanks

baseball29 profile image
baseball29 in reply toE2-Guy

Thank you I will take a look.

Zot1 profile image
Zot1 in reply toE2-Guy

Hi , Is it prescribed by the doctor the tE2 gel. How do you use it? You mention no doctor visits. You don't do blood test to see the results??? Thanks for your advice.

E2-Guy profile image
E2-Guy in reply toZot1

I am able to buy tE2 gel here without a prescription and I get trimonthly blood tests from our government hospital without seeing a doctor.

Zot1 profile image
Zot1 in reply toE2-Guy

If my dad will buy it , how can he use it? Thank you for your time.

E2-Guy profile image
E2-Guy in reply toZot1

All of your questions should be addressed in my numerous trimonthly blood test results. 1.5 mg/day applied to your lower abdomen, inner thighs and scrotum should be a starting point.

Coupe31 profile image
Coupe31

Hello baseball29. I'm in Vegas too and my MO also retired this past several months. Dr. Vogelzang. I bet we had the same MO. If I am ask, who is your new MO?

baseball29 profile image
baseball29 in reply toCoupe31

Yes we did! Dr Goodman is my new MO.

Fightinghard profile image
Fightinghard

Your testosterone should not bounce back much immediately even if you cancel your scheduled shot. So no impact on scans either way. My opinion - get your Eligard shot on schedule and get the scans.

DonM253 profile image
DonM253

I’d get the PSMA scan. The scan will show how serious the cancer is so you’ll have a better idea. As far as eligaard goes just wait a week. Your PSA is only .3

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