Profile recap: family history of PCa; RALP 5/18/09; post-surgery pathology Gleason 3+3; no evidence of PCa extracapsular or in pelvic lymph nodes. Post-surgery PSA undetectible until 2013, then reached 0.20 in 2017. Most recent PSA 0.56 in January 2023.
Scan was performed on 3/9/23 by Department of Radiology at Columbia University Medical Center/NewYork-Presbyterian Hospital, New York City. Here are the report highlights:
1. No convincing evidence of distant PSMA-avid metastases.
2. Head/Neck: There is no pathologically enlarged or PSMA-avid lymph node.
3. Chest: Mediastinum, hila and lymph nodes: There is no pathologically enlarged or PSMA-avid lymph node.
4. Abdomen: There is no pathologically enlarged or PSMA-avid lymph node.
5. Pelvis:
a. Lymph nodes: There is no pathologically enlarged or PSMA-avid lymph node.
b. Soft tissue: Status post radical prostatectomy. There is a 0.9 cm focus of intense PSMA uptake in the prostate bed, adjacent to the left posteroinferior bladder wall, corresponding to an ill-defined soft tissue nodule on CT (SUV max 40.5, average Hounsfield units 50, 4:81, 3:47).
My PSA has been relatively steady for the past year:
11/17/21 - 0.51
03/07/22 - 0.53
06/14/22 - 0.44 (not a typo - point forty-four)
10/08/22 - 0.54
01/17/23 -0.56
My doubling time is anywhere from 2 to 10 years based on which data points are used in the calculations.
Under the circumstances, I have several questions:
1. Is it possible that the rise in PSA is caused by benign residual prostatic tissue?
2. Is follow-on treatment necessary at this time (or ever)?
3. My medical oncologist has been suggesting that I participate in his clinical trial ( clinicaltrials.gov/ct2/show... ). Is this worthwhile or would this be over-treatment in my case, and would there be any downside?