PSMA PET scan

[baseball29]

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.

[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 in reply to tango65]

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 in reply to baseball29]

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 in reply to tango65]

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]

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 in reply to Tall_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 in reply to baseball29]

I just said what I think.

[baseball29 in reply to Tall_Allen]

Thank you!

[cesces]

What is the doubling time of your PSA?

[baseball29 in reply to cesces]

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

[cesces in reply to baseball29]

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

[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 in reply to E2-Guy]

Can that be used along with Lupron? Thanks

[E2-Guy in reply to dhccpa]

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

[dhccpa in reply to E2-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 in reply to dhccpa]

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 in reply to E2-Guy]

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

[VHRguy in reply to dhccpa]

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 in reply to VHRguy]

Thanks

[baseball29 in reply to E2-Guy]

Thank you I will take a look.

[Zot1 in reply to E2-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 in reply to Zot1]

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 in reply to E2-Guy]

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

[E2-Guy in reply to Zot1]

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]

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 in reply to Coupe31]

Yes we did! Dr Goodman is my new MO.

[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]

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