Will a PET PSMA scan still essentially function as well to find out where PC lesions exist if one's PSA is low say <1, because of Lupron?
Lets say the PSA without Lupron might be a 10, (also no prostatectomy was ever performed.)
My radiologist wants me to get the scan so I can then get set up for IMRT and possible SBRT.
If you've been on hormone therapy for a long time, nothing may be visible on a PET scan.
I recently had a ct scan with contrast it came back unremarkable now they are sending me for a nuclear scan for my bones have mets to bones in 4 places on adt treatment for 4 .5 years psa hovers from 1.5 to 2.5 still have prostate never had chemo radiation on firmagon I was hoping they would be able to see excatly what is on my bones
same here. I've been on Lupron only for almost 4 years. PSA last was 0.66. But my last Axumin PET a year ago still showed uptake in several places. New scans coming up before end of year.
Do you have bone pain? Is it possible that you have false positive findings? How do you know that you have active mets? Coud they biopsy your mets?
Could you ask for 68GA PSMA PET scan if the biopsy comes out negative?
I am not a doctor but I wouldn't add anything to your medication until you are sure that with stable PSA your mets are not just false positive.
Would you sbrt your bone mets if they come out as active mets? Usually i belive radiation is only recommended for paliation but I am not an expert. Could you contact a radiation oncologist for opinion? Who is treating you now? MO, urologist, radiation oncologist or the team?
I have both an MO and an RO. The general thinking is that I am not a suitable candidate for any radiation.
I have aches and pains here and there in bones, but they seek to shuffle around and do not seem tied directly to the mets.
The mets are supposedly there because increased SUV is showing in those spots, compared to background SUV.
I have not had a biopsy. If it can be done at Medicare's expense, I'm all for it. No one has yet recommended it. And that would be the only way to determine for certain, if even that could do it.
PCa diagnoses and evaluations seem to operate heavily on indirectness: PSA levels, digital rectals, even scans and biopsies are interpretations. Once the next evaluator knows your high PSA and Gleason score at diagnosis, they're off and running, rightly or wrongly.
do you have bone pain? What is the PSA doubling time? How do you know that the findings are not false positive? How big are the mets? Could you biopsy your mets? Would it be possible?
Maybe you should just get a 68GA PSMA PET scan if you don't have a bone pain in order to find out are they real mets so you could maybe SBRT them? It is only my idea. Do you have a radiation oncologist (RO)?
My PSA was 1.09 when I got my PSAM Pet/ct scan. Hit on two lymph nodes. I was told your PSA needed to be above .5
Actually, when I took the ADT vacation, the rationale was to "wake" up the tumors; then proceed with PSMA directed radiation.
We waited for PSA > 1, because at the time, ADT was working for undetectable status. So, the risk was calculated for the benefit of seeing the tumors for a kill shot, instead of "kicking the can down the road" strategy.
All the best...
interesting. Seems difficult, as I thought, to see how effective the pet Psma is with a low Psa due to lupron
Have heard and read that want PSA of 0.6 as minimum for PSMA PET. A little higher is better, much higher doesn’t seem to matter.
My PSA was only 4.7 t diagnosis 12 years ago, G7 at biopsy, but upgraded to G9 at surgery. It has never been too far above that except when it suddenly spiked in 2018 when I developed Lupron resistance and went into chemo to rein it back under control (doubling time was just weeks at that point). So my PSA has never been high and I'm guessing any G9 cells must have been taken out at surgery, or else it seems it would have been more aggressive in the years since. Nubeqa has been doing a great job for the past 2.5 years. It has very slowly risen, but as of a few weeks ago I was at only 0.36, which was actually up about 50% from the one three months prior. The timing for that last one was unfortunate. It was a regularly scheduled draw for my MO, the problem is that this summer I decided to have an RO zap the 3 lymph nodes that have, since my first scan not long after surgery, been a little enlarged. The PSA was drawn the day before the last of my 5 radiation treatments this summer. No matter whether I've had older scans, or the latest PSMA scan, it has always been confined there. So yes, in my experience a scan can show it if it's there, to about the same level as it shows even when it's several points higher. Just my personal experience.
PSMA PET scan results 
Cost of PSMA pet scan
PSMA Scan with PSA<0.006 
PSMA PET Scan Shows no mets?!
PSMA versus Traditional PET scan
