I was diagnosed with Stage four in October 2021 (Gleason 9 in all sites). Been on Lupron and Zytiga with Prednisone since November 2021.
Numerous MRI's, CT scans, and bone scans over course of first year indicated multiple bone mets in pelvis, rib, elbow and shoulder. Also moderate to severe arthritis and neuropathy. The mets did not progress during the year.I have had periodic pain in pelvis, hips, legs, and right side, which have been severe for weeks at a time, and then almost disappear for weeks also.
My PSA had bottomed out at
. 04 for past three readings (nine months). But most recent one (November 9, 2022) had jumped to . 19.
My MO (late November 2022) ordered a PSMA-PET scan. I'm not scheduled see my MO until February, but my interpretation of the results is that God has intervened. The report said I only have one site in L4 vertabra, and it is rated 4 on 5-point scale (moderate). NO OTHER abnormal results on bones, in cranium, lungs, other organs, lymph nodes, or prostate bed! Needless to say, I am cautiously elated and praising God.
I have a PSA of 0.17, but the sensitivity of a PET scan indicates that nothing will appear. Before rising to 0.5 there is probably a waist to have a scan.
I think you answered the question..but let's hope that PSA never reaches 0.5, let alone higher where the sensitivit increases even more.....and the accuracy still limited by metastasis size, no matter the PSA...right?
I'm assuming that the PSMA scan would show my original mets if they were still there. So what I see as miraculous is those original mets are gone, except for one. Of course I may be misinterpreting the report. Haven't seen MO yet.
Hormone therapy makes the mets shrink in size. So they may have become too small to be visible for a PSMA PET/CT at a PSA value of 0.19. A PSMA PET/CT is more sensitive at higher PSA values. I had to wait for the PSA value to get to 3.0 ng/ml until mets became visible.
The sensitivity rates of PSMA PET/CT according to PSA levels are 55-60% (0.2-0.5 ng/mL), 72-75% (0.5-1.0 ng/mL), 93% (1.0-2.0 ng/mL) and 97% (≥2.0 ng/mL).
This is why I will wait until I have 0.5. I am thinking of having a luPSMA treatment and it works best with very low tumor byrden in the lymph nodes only. If nothing shows up I do another at 1. If all the lesions show medium to high SUV uptake I will be informed of a potential good outcome.
you have been blessed and rightfully give praise. My PSA went to undectable and stayed there for months. I’m taking AVEED and trying to return my body to normal. We keep an eye on PSA. Congratulations and best wishes for continued blessings
Sounds like you're doing quite well. I also had Gleason 9, and have went through Erleada, Xofigo, and Zytiga. Now on Chemo with one session behind me. Last PSA was 227, so if the chemo doesn't work, I don't think there is much left for me to try.
That is an abbreviation SHH696 made up on the fly. It refers to Lu177 and Ac225 nuclear therapy. Here is an article discussing this: urotoday.com/conference-hig...
I understand the therapy. I just don't know why SHH696 said I HAVE it.
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There must be a misunderstanding here? Are you refering to my comment that we as pCA patients have both luPSMA and acPSMA in the toolbox?
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LOL, Yes, I misunderstood your comment "Well, you have lu/acPSMA." I thought that was an acronym for some pc variant that I was unaware of!
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lutetiumPSMA is a beta emitter that latches on to the antigen presented on the surface of the cancer cells. Penetrates 1.6 mm and induces DNA damage. actinumPSMA is an alpha emitter 10 times stronger and penetrates much shorter, but creates much more damage. Unfortunately our salivary glands also produces PSMA, a bad side effect of acPSMA is Xerostomia - dry mouth. Both therapies can be very effective IF ALL you lesions show high density of PSMA. A PET scan will reveal this. They measure the density in SUV, the number should be above 10, A combo of low dose ac and high dose lu can be very effective under the right circumstance.
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I understand the therapy. I just don't know why you said I HAVE it.
So sorry that your stats aren't so good, but continue every treatment you can find. And remember the awesome power of prayer!
trust in science Science is responsible for all the treatments ,drugs and scans that we are subjected to while fighting this terrible disease The truth is if you have stage 4 metastatic castrate resistant prostate cancer Nobody gets out alive. If you find comfort and solace praying to your God that is clearly your choice . I am putting my faith in science
I was diagnosed with PC on my 65th birthday Nov 2018, a Dec biopsy proved out to be gleason 9 my PSA was 22 I started Zoladex and the 28 rounds of EBRT in may/june 2019
PSA dropped to 0.1 but gradually climbed up to 14. A PSMA Pet scan show tumors on L3 T9 and T10. I had SBRT at UCLA in June 2021 stayed on Zoladex PSA started to rise again in Jan 2022 and was doubling every 4 weeks. I had another PSMA Pet scan in June 2021 which showed 2 more tumors L4 and upper right lung hilum Started Xtandi in July 2022 PSA has now dropped to 0.27 still to high considering the drugs I am taking. Looks like another PSMA PET scan in January 2023 and the decision time. More SBRT? who knows
but I can guarantee your God isn't going to change any outcomes. I mean really how well god doing with mass shootings of children
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PSMA PET scan results 
PSMA Scan , help with findings
PSMA scan
Lu-177-PSMA First Infusion 
First Post and PSMA Scan Planned
