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.
Uptake of what?
Request a MRI of the area to see if bone marrow is affected.
Anything is possible with this cancer. Hope for a false positive.
What was the SUVmax? Low uptake in ribs seems to be typical of false positives.
What is low, just matter of interest?
Low=not much greater than background
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.
Could it just be dormant?
Docs don't think so. Probably an old injury showing up in the bone scan, not a met.
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.
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
Sartorial is one of the best! 👏👏👏
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! 🙏
HOPE IS ALIVE. Original PSA 209 with bone mets 8 Years Ago, still undetectable <0.10 as of today
PSA 0.01 Undetectable at last !!!
PSA still undetectable
PSA of <0.1 undetectable?
Latest PSA! Undetectable 
