My husband is scheduled for a PSMA scan February 24. His PSA was .86 on February 2. Been rising from .08 since October. I recall seeing a post from Tall Allen that stated the size the cancer has to be to be picked up on the scan, but I can’t seem to locate it. Last time he was scanned in January 2022, only a lymph node in the hilar region was identified
how sensitive is the PSMA scan? - Advanced Prostate...
how sensitive is the PSMA scan?
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Drandma
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The short answer is VERY. Most people, including docs, correlate the detection capability of the scan to the PSA value. This is half, or even less than half, the truth. PSADT plays an equal or a more predominant role. Sadly, your husband has a very short doubling time (just hope that his latest PSA test was nothing but a lab's error). If you want an extra boost to the PSMA scan let him take an anti-androgen (Enzalutamide better, Bicalutamide second best) from now until the scanning day. Initially, administered anti-androgens augment the PSMA expression of the tumors.
I had two psma scans, one with a psa=.5 which found nothing and one with a psa =1.5 which found many LN’s Mets.
thank you for responding. I hope you are doing okay
Almost same for me: scan found 0 with PSA 0.2 and 3 PLN mets with PSA 1.4. We radiated prostate bed and pelvic floor with IMRT/VMAT one year ago and under lupron my PSA is undetectable since then. Still I do another PSMA-PET/CT in March on my docs request.
is there a reason or a benefit of doing a psma at undetectable psa? My MO told me to wait until it reaches .2 and then do the psma scan
You mean PSA 2.0? Yes, my doc wants to compare results of the recent with the older ones, also the CT scans.
no, mine is .08 now and he wants to do the psma at .2 or greater.
What more do you need to know? A hilar lymph node is outside of the pelvic region, so it is stage M1a. There are many more you can't see, but what is the difference - he still needs systemic therapy.
I realize he needs treatment. He would hope that the scan can provide enough information for him to make a decision about his farming operation. His partner retired and he is starting a new farm on his own. It will require putting up around $500,000 before he even is able to harvest any crops. If it has spread beyond M1a, I’m not sure what his decision will be.
If it is in the hilar lymph nodes, you can be assured that there are micromets all over. But I don't understand how that changes his investment decision. Systemic therapy will delay progression, but no one can tell you for how long.
I agree. I’d like to see him decide to farm on his on. I think he’d just like to know if it’s in the liver or not. I think he would definitely retire if that’s the case
TA, just curious. Do you think I am M1 too? I don’t think it will make a difference but to know my disease. Thanks
Where are your metastases?
This is from dr. Morris’ s notes:
” Rising PSA Non-Castrate - mets by PL to peritoneum, splenic LN “
Yes, that's M1a - well outside of the pelvic lymph node drainage area.
Is there any statistical information on how long M1a Mets patients live? Thanks
In general, the prognosis for M1a>M1b (and lung)>M1c
I guess you and I share the same M.O. at MSKcc.....Dr. Michael Morris...
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 02/14/2023 11:06 PM EST
Hi. My prostate was taken out 2002 in Toronto . The first five years my PSA was -0 Than it started moving up and now it is at 45 . Have had many scanners but they can't find anything . What should i do ? I am not taking any meds so far only herbs and teas i am worried. Thank you .
Unless you are 90 years old, ADT will improve your survival.
I am 68 and what is ADT I don't know much about those things ? Thank you .
ADT=Androgen Deprivation Therapy, Androkur, in your case.
Thank you much . Have a great day .
Still learning what is the systemic therapy you mentioned? Provege ?
It is the only immunotherapy approved for mCRPC in the US. Keytruda only approved for a rare circumstance.
He has never tested positive for Covid. I don’t recall the size, but a needle biopsy obtained through a procedure he had done did in fact confirm that it was metastatic carcinoma, consistent with prostate primary. The doctor did indicate it was atypical
I had PSMA at UCLA and it found a lesion in the Left top of Prostate gland. On Biopsy at Sloan Kettering it was found that there was actually another lesion bilaterally on the right side of the Prostate as well (not microscopic -of significant size) . PSMA not perfect.. Good Luck to your husband
My PSA was undetectable on an ultra sensitive PSA test for about 6 years, then a little over a year ago it became detectable again and slowly began rising. When it reached 0.17 my MO, Dr. Sartor, recommended that I get a PSMA scan. It showed a highly suspicious area of uptake on one of my ribs. I had SBRT on that spot and my first PSA post SBRT showed a 30% decline in my PSA. We’ll see if that trend continues on the next test.
So to respond to your question I’d say very sensitive.
Ed
Dr. Sartor is my husband’s MO also. Are you planning on following him to Mayo
I was not aware he’s moving to Mayo, do you know which location?
Minnesota. Received an email from him last month. Will be gone end of March
Interesting. I've read that Dr. Kwon is hostile to BAT. Think there'll be fireworks?
Ya I looked into it and saw that it’s MN which is a bummer for me, I live in GA. I’ve been texting with him today and seeing what needs to happen in order to continue having him coordinating my treatment. There’s a Mayo in FL that may provide a solution.
Ed
we are in Mississippi. My husband has a scan on February 24 and then a phone consultation with Dr Sartor on March 13. Not sure what we will do moving forward
If you live in GA, check out MD Anderson in Jacksonville, too. I have been pleased with them as I have been involved for about a year now.
This was my experience w PSMA PET. I got my scan in January, 2020 and had to be the 1st man from Florida to get this scan. Had to fight for it because I as on ADT and muy PSA was low...but I was told by Dr Calaise at UCLA that if I had MET that the tumor would show up on the scan even if it was not putting off PSA due to my being on ADT. The tumor antigen (surface) is still there even if its not putting of PSA due to ADT...so I did the scan, came up negative for MET and proceeded to IMRT RT...had I found MET I would not have gone forward with radiation. That's the importance of this scan. It will find tumors down to 2mm I believe...take a look at these posts (if you have not seen them)...good luck. Rick
I have had three PMSA scans, approximately six months apart, the last of which occurred three weeks ago. My sequential PSA scores taken one week before each scan, were .82, 1.61 and 3.76, respectively. Each scan has been negative. My prostate was removed six and a half years ago. I received thirty eight rounds of radiation directed at the prostate bed three years ago. My scans were at UCSF, UCLA and the last at an Intermountain Healthcare facility in Utah. Gallium 68 was used for the first two scans, F-18 for the most recent one. My docs, and I are surprised each time I'm scanned because nothing shows up. Any thoughts about my rapidly climbing PSA #'s and negative scan results will be appreciated.
My Pylarify scan picked up a ton of lymph nodes, none of which seemed to have been very big.
My PSA at the time was 1.23
My father had a PSMA scan at .23 and they found a uptake in L3 but claimed that was false positive. The new scans F-18 can somewhat be too sensitive and give false positive results. However dad is not on ADT, just did ralp almost one year ago with a T2, gleason score 3+4. No positive margins. Why his PSA doubled after 5-6 months noone knows. These last couple of months the PSA been fluctating down ( knock on wood!).
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