Need help explaining my new psma scan... - Advanced Prostate...

Advanced Prostate Cancer

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Need help explaining my new psma scan please.

Ahk1 profile image
Ahk1
23 Replies

This is my new psma scan report. Would you please when you have a chance, share your thoughts about it. Is it a bad report? I am not on any treatments for 18 months now since I had the psma scan that the report is comparing it to.

Thank you in advance

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Ahk1 profile image
Ahk1
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23 Replies
Ahk1 profile image
Ahk1

sorry, the first portion of the report didn’t load

Psma scan report
Tall_Allen profile image
Tall_Allen in reply to Ahk1

Unchanged (and in some cases, decreased mets) is better than if it were deteriorating. But you continue to have detectable metastases in some lymph nodes.

Ahk1 profile image
Ahk1 in reply to Tall_Allen

Thanks, TA. do you think the reason for the current status of Mets is because I took the 18 months vacation? Do you think I should go back on ADT immediately? Thanks again.

Tall_Allen profile image
Tall_Allen in reply to Ahk1

That's a decision only you can make. You have to consider how the T vacation makes you feel and if the QOL improvement is worthwhile.

GP24 profile image
GP24

As long as there are no bone mets it is not a bad report. These lymph node mets won't kill you.

Ahk1 profile image
Ahk1 in reply to GP24

Thank you. Even if they didn’t decrease or go away, they won’t be of a major problem?

GP24 profile image
GP24 in reply to Ahk1

As long as they do not grow a lot, they cannot cause a major problem. If Pluvicto becomes available in your situation this could take of these mets.

treedown profile image
treedown

I would in my limited capacity be OK with it based on the words Unchanged and decreased. If mine I would want to look at the previous scan because it appears they are 75% sure there's something there that's metastatic but limited to your pelvic and peritoneal areas. What did you MO say about your last scan? If they were happy with that one I would interpret it to be happy with this one. I am curious to hear what a implant is

6357axbz profile image
6357axbz

Didn’t your MO summarize it for you? What did she/he say?

Ahk1 profile image
Ahk1 in reply to 6357axbz

I just got the report from the portal. I will see my MO in a week from now but was just anxious to know what patients on here think.

Cateydid profile image
Cateydid in reply to Ahk1

I understand how you feel waiting for the doc.

I read my husband’s PSMA PET scan report the day after the scan was done. I read it very differently than the onc did! I saw mention of rib fractures near mets, and potential salivary gland and pancreas affectation, as well as the spots in his chest and the one at the base of his spine. Doc only mentioned the spine and the chest. When I asked about the ribs, he said he can’t be sure about those. Dang it: they lit up, didn’t they???

Heading to the James @ OSU and then to Mayo for additional consultations.

Grandpa4 profile image
Grandpa4 in reply to Cateydid

there are a lot of false positive rib lesions.

fmenninger profile image
fmenninger in reply to Grandpa4

Why is there slot of false positives on a psma pet scan? Do you need an fdg pet and mri as well to confirm?

Cooolone profile image
Cooolone

It's ok to ask NON professionals their opinion, and we all completely understand the anxiety involved with seeing a scan result that we don't understand, but asking online for answers sometimes may be akin to just asking Dr. Google! It will just lead to more stress, lol.

As much as it's tortuous, waiting for the oncologist explanation is always best. And if you don't understand what he/she has presented, you ask for it to be explained until you do. THEN discussing the results is worthwhile... Because doing the reverse only leads to more anxiety.

The scan is the scan... Biggest question from obtaining scan result(s), is time. Based upon the results should I be doing something I'm currently not, that would help, or mitigate what's seen?

But what do we gain when we want to take a peek at the scan, and don't understand it... We load ourselves with anxiety as you've noted. Always expecting to worst, and left with "what if" questions!? I only say these things because I'm left wondering how much stress as cancer patients, we cause ourselves? Trust me, I get it... But I'll share a funny experience just recently I've come across.

So last month, I'm walking from my car to the hospital for my labs and Firmagon injection... And while walking it hit me suddenly, and was a weird experience. It was the first moment that I thought about my labs and what the PSA reading might be, along with other metrics being measured due to my drug regimen. It was weird because usually this is days before, the night before, the typical anxiety we all face when thinking about this disease we face, and what might be coming on the horizon. But that day, I wasn't concerned, it wasn't hanging in the back of my mind, etc. And I realized then, that this was a good thing... I wasn't concerned with what might be, and knew to await the results and it would be what it was, is... And then, only then, lend any attention to it that may be required. Otherwise, not so much to care...

So, my recommendation is to try and do the same. Relax, wait for the oncologist to explain and declare what has been found, what it means, and what course of action is available. But worrying about it until then doesn't help. I know, I know, I'm preaching to the choir. But my recent experience was amazing. Try to free yourself from the stress and hopefully you can do the same!

Best Regards

Cateydid profile image
Cateydid in reply to Cooolone

great feedback, Cooolone. I’ll consider your idea.

It would be so much easier to do if I had more confidence in the onc. For example, after he shared his interpretation of the scan, he suggested my Joe might try chemo(which nearly killed him 2 months ago), or Nubeqa (which this doc prescribed at our last visit and which Joe has been taking for a month)…..

this doc is also dead set against radiating the mets found on the scan. Not “let’s consider that as an option”……

Hence the additional consultations. Looking for a doc who is willing to peruse Joe’s chart before our visit so he-or she-knows what they’re talking about when we see them.

tarhoosier profile image
tarhoosier

Onc reviewed my psma scan with me this week and we traveled down my body from skull to pelvis. His comments: "I (onc) look at many of these scans. The eye and salivary glands appear in heightened color (yellow/red) as natural locations for the isotope uptake and not related to metastases. The liver and spleen are brighter because they are infused with blood and are not related to metastases." These were among his comments on my results. FYI.

I had one index lesion on L3 spine and another possible on pedicle of vertabra near scapula though of lower confidence and significance. Referred to radiology oncology for X-beam radiation of L3.

tarzan11 profile image
tarzan11

I just had psma scan done. Countless bone mets from femur to mandible. Lymph nodes too. This is my 20th year of PCa treatments with several holidays. This scan came after a 6 month holiday while I underwent two surgeries for other things. It came on fast. Anyway your results look wonderful to me. It's all perspective.

NecessarilySo profile image
NecessarilySo

Not much to worry about now, very slow growth of PC , but I would watch the PSA quarterly and let it guide you to therapy.

RoseDoc profile image
RoseDoc

Seems as though nothing has changed since the last scan. That is good! You do, however,have metastatic disease which has a possibility of spreading. You and your oncologist need to discuss the pros/cons of treatment vs. watchful waiting.

j-o-h-n profile image
j-o-h-n

I apologize if I previously asked you this question. Who's your M.O. at MSKcc. Thanks.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 05/10/2023 7:54 PM DST

Ahk1 profile image
Ahk1 in reply to j-o-h-n

we both have the same doctor. He is the BEST.

fmenninger profile image
fmenninger in reply to j-o-h-n

whose your MO at mskcc?

j-o-h-n profile image
j-o-h-n in reply to fmenninger

Dr. Michael Morris.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/11/2023 8:19 AM DST

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