Undetectable PSA but new bone uptake - Advanced Prostate...

Advanced Prostate Cancer

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Undetectable PSA but new bone uptake

Heykm01 profile image
14 Replies

I had my 3 month scans and blood work as part of arasec trial (Lupron + darolutamide). The good news - PSA is <0.01. Previously diagnosed M1b.

The bone scan however picked up “new focus of uptake in lateral left 11th rib”. Radiologist labeled it indeterminate, doc believes it to be false positive based on PSA.

Any experience here - is it possible to have progression at undetectable PSA?

Scans coincided with debulking IMRT radiation - around day 14 of 20.

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Heykm01 profile image
Heykm01
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14 Replies
cesces profile image
cesces

Uptake of what?

tango65 profile image
tango65

Request a MRI of the area to see if bone marrow is affected.

Poowater profile image
Poowater

Anything is possible with this cancer. Hope for a false positive.

Tall_Allen profile image
Tall_Allen

What was the SUVmax? Low uptake in ribs seems to be typical of false positives.

anony2020 profile image
anony2020 in reply toTall_Allen

What is low, just matter of interest?

Tall_Allen profile image
Tall_Allen in reply toanony2020

Low=not much greater than background

Garbonzeaux profile image
Garbonzeaux

At diagnosis, I had several bone mets, and one spot on a rib was thought to be one of them. With treatment, all the others faded away, but no change on the rib. So clearly, it wasn't really one.

dhccpa profile image
dhccpa in reply toGarbonzeaux

Could it just be dormant?

Garbonzeaux profile image
Garbonzeaux in reply todhccpa

Docs don't think so. Probably an old injury showing up in the bone scan, not a met.

Brightman profile image
Brightman

My recent whole body bone scan (Feb 2nd) showed an uptake on my 6th rib as well. My psa is <0.01 too. So my oncologist said we would wait and see with that. I had a new cancer on my T10 vertebrae diagnosed in 2021 which was radiated using the SBRT method and that has basically cleared. My original diagnosis in 2016 showed 4 Mets including on the T11 vertebrae. I had radiation and chemotherapy then. My scan this time also showed a small fracture on my T9 vertebrae, so have had an Xgeva injection to strengthen my bones and am on Palexia for pain there. So there are lots of options for you.

EdBar profile image
EdBar

My PSA was undetectable on an US PSA test for several years, a little over a year ago it became detectable again. When my PSA hit 0.17, my MO, Dr. Sartor recommended a PSMA scan. It showed an area of substantial uptake on one of my ribs. Sartor was skeptical, he said that ribs often are the source of false positives, but with the radiology report calling it highly suspicious, I went ahead and had SBRT. First PSA after SBRT showed a 30% decline in PSA. We’ll see what future tests show, hopefully it wasn’t a fluke.

As others have said, I think it depends on the amount of uptake, the fact you’re undetectable is a good sign.

Ed

in reply toEdBar

Sartorial is one of the best! 👏👏👏

dhccpa profile image
dhccpa

Blood tests can also lead to fear of even a small rise in this or that. Regular part of life now.

no Psa is great . I pray that the uptake on the scan is false! 🙏

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