PSMA PET scan?

[davidw777]

PSA undetectable for last 18 months.

I have been taking abiraterone & lupron & I am considering a treatment 'holiday'.

Would a PSMA PET scan be beneficial ?

[treedown]

It most likely would not find anything. You kind of have to take a leap of faith and monitor your PSA after you stop. YOu may want to have an idea ip front if restarting the drugs will be once your PSA hits a mark or if you will wait until mets are visible on PET/CT. My insurance made me get CT and BOne scan before they approved the PET/CT.

[davidw777 in reply to treedown]

Thanks for the input.

Unfortunately my insurance has denied the PSMA PET scan without an increase in PSA. Out of pocket is substantial, so I'm trying to determine if I should pay myself to have the scan.

[treedown in reply to davidw777]

I am not surprised. I don't think it would find anything anyway so my opinion is that you would be wasting your money. What I said above applies to you as opposed to others with better insurance that follow their Dr's requests without question. Depending on where your at in treatment, sorry did not read your profile, you may need to wait until your PSA gets to 2, if radiation was primary treatment and this is the first "holiday". So if your PSA takes a long time to get there than yay. If your uncomfortable watching it grow than you need to decide to restart PSA at say 1.0 or .5.

I went to 2, the PERT found mets in my spine, I went back on HT in March at a PSA of 3.26 and as of yesterday my PSA is .12

[dhccpa in reply to davidw777]

Perhaps they would pay if you stopped treatment and it rose while off treatment, but I've never tested that.

[MateoBeach in reply to davidw777]

would not be worth it as PSMA would not show anything with undetectable PSA. I would proceed with the vacation and monitor PSA (and enjoy it). Get the PSMA

Scan when PSA hits a selected value such as 0.25 or 0.50.

[6357axbz]

My MO had me do a Pylarify scan when my PSAwas undetectable and before I went on a medication holiday. She said it was to establish a baseline.

[Tall_Allen]

Not now. It is highly PSA-dependent.

[Hidden in reply to Tall_Allen]

It will still show his mets at undetectable.

Showed my lymph node when I was undetectable.

But not worth paying out of pocket.

[London441 in reply to Hidden]

Your saying that ‘it will still show his mets at undetectable’ is based on that it did for you?

[fireandice123]

My insurance required my PSA to be at least 1.0 before they would approve my PSMA scan. And they also required bone and CT scans.

[austinsurvivor]

my insurance, BCBS, denied my PSMA scan so I got an out of pocket quote from RMCC of $6500…..pretty pricey considering I had one done at UCLA medical a couple years ago for $2500

[RMontana]

...absolutely, yes get a scan. Why on earth NOT know that, at the point your starting your vacation, your clean, clear and cured of any tumor or growth. I know PSMA PET does not pick up small tumors, nor PCa cells floating around, but any significant tumor it will find...now PSA levels affects its 'Sensitivity,' meaning whether it will find PCa, but even with low PSA it can still be revealing...check out this article if you need info on that.

healthunlocked.com/active-s...

...also do all your baseline bloodwork. Know what your TET (testosterone) levels are, your A1c, your Hemoglobin...the works! Know where you are starting from so you can measure progress or regression...many times these tests are not run and we dont know if we had a symptom, or condition before we started our next treatment regime, or not. For example, I was not given a PSA or TET blood test before I started IMRT sRT and it affects my ability to use a lot of nomograms for prediction of progression. I also dont know at what level I went into treatment, so as to know if and when I reach parity with pre-treatment health levels...did not know to ask so dont have info to use...

If you are looking for other blood tests, or tests in general to take to get baselines here is great Mapping of those tests which show what we can consider at different points; if you dont have genomic or germline testing you may want to consider these...who knows what that may reveal for you, or for your direct male family members.

healthunlocked.com/active-s...

[reconjj]

Hello David 777 , Im currently 14 months on the same protocol as you , ADT , ( Eligard ) Zytiga , pred. . and undetectable . At the 2 yr. mark the latest study that tall Allen showed , I believe the Stampede trial , was to stop Zytiga and pred. but continue with ADT for 1 more year alone . That will be my plan if everything stays good . Good Luck . JJ