Post Docetaxel scan, which one?

[Jay-kud8]

68yrs. Gleeson 5+4 T2cN1M0 Cap Sept 2023.

PSA at diagnosis 27.

mpMRI at diagnosis pirades V2= 2!

Small prostate volume 22mls ( have been on Dutasteride)

CT at diagnosis minimally prominent left pelvic wall nodes nil else.

F18 PSMA Sept 2023 : pelvic lymph nodes + para aortic nodes, highest lymph node below left renal vein. T2cN1M0.

TURP for bladder outlet obstruction October 23 before chemo. Histology showed no caP. 10g resected.

Treated with LHRH analogue and Docetaxel.

PSA now <.03. Last dose of Docetaxel due on 3rd May.

Given previous CT and MRI scans having shown no abnormalities and PSA at <.03 which scan to go for to assess response to Docetaxel therapy?

(PSA came down to <.03 even before Chemotherapy!)

Thanks in advance for any suggestions.

[Tall_Allen]

What treatment decision are you trying to make? I'm not sure why you had docetaxel at all, since M0. Discuss 3 years of ADT+ 2 years of Zytiga along with whole pelvic RT.

[Jay-kud8 in reply to Tall_Allen]

Thank you. What you have suggested has been planned but with Enzalutamide. Docetaxel was to treat micro mets not seen on the staging scans at the very outset when I could tolerate it best. The post Docetaxel Scan is routinely arranged . I was not sure of the value of it as it is unlikely influence the treatment planned, I will avoid the unnecessary radiation.

[spencoid2]

do you mean Gleason 5,5 the scale only goes to 5

[Jay-kud8 in reply to spencoid2]

Sorry typo error! Should read 5+4

[spencoid2]

me too 5,4

[Gl448]

I would think whatever scan your doctor recommends is the best scan to go with.

I’m having my final docetaxel on April 25.

Doctor has already ordered the follow up scan. I wanted a fancy new PSMA scan, but since my original urologist (ignorantly) ordered an Axumin scan, we’re going with Axumin again. MO says easier get approved and comparing apples to apples.

[Jay-kud8 in reply to Gl448]

Thank you