Tests/Scans etc

[NickJoy]

Does anyone know if there are any blood tests that would indicate whether the cancer has spread and become neuroendocrine? My husband has monthly PSA and Chromogranin A blood tests . PSA remains undetectable but Chroma A is creeping up but still low. His oncologist is not keen on extra scanning but without this how do we check for any progression that isn't indicated by the PSA level? Are there other blood tests that would give us a clue?

Thank you.

[Tall_Allen]

Why would you even suspect such a rare thing? Chromogranin A blood test tells you nothing - you have to biopsy a met.

[NickJoy in reply to Tall_Allen]

The biopsy histology of the prostate showed a large % of neuroendocrine cells but the diagnosis was adenocarcinoma - we just wondered if there was any way of checking if there was progression as his PSA has always been low and I thought I had read that annual scans were suggested but I wasn't sure where I read it. The last scan was over a year ago.

[Tall_Allen in reply to NickJoy]

IHC is the only way I know of. Lytic bone metastases are a clue, but are not definitive.

[Sailing-Todd in reply to Tall_Allen]

Hi, please can you expand on Lytic bone metastases not being definitive? Many thanks.

[Tall_Allen in reply to Sailing-Todd]

Nothing to expand.

[TeleGuy in reply to NickJoy]

I am guessing from your wording that since the diagnosis was adenocarcinoma, that your prostate cancer cells are showing neuroendocrine differentiation and are not fully neuroendocrine? That is the state I'm in and we are watching Chromogranin A, doing biopsies, and doing FDG PET since that will show both prostate and neuroendocrine-differentiated cells that are gobbling up sugar. PSMA PET will show up prostate cancer cells that are exhibiting PSMA, but that's not always going to highlight the neuroendocrine side.

[NickJoy in reply to TeleGuy]

Thank you. I will try to get a FDG PET - how often do you get one?

[TeleGuy in reply to NickJoy]

Not on any regular basis, just when there’s a need, such as. “My PSA is rising, what is hot?”

[NickJoy]

That is very helpful. Thank you.

[Portugal-2]

Are you getting the highly sensitive PSA blood test or the regular ones. Makes a difference. But honestly I agree with Tall Alan.

[NickJoy in reply to Portugal-2]

Thank you - I will check.

[dhccpa]

Great question.

[MateoBeach]

Agree that scans at least annually should be done. PSMA PET is best if your cancer is at all PSMA avid. Perhaps Axumen if not? Otherwise bone scan and CT are standard.

[NickJoy in reply to MateoBeach]

Thank you.

[NickJoy]

Just wanted to check is it the 18 F-FDG scan you mean for the bone scan? Thank you.

[Ahk1]

what is your current chromogranin A number?

[NickJoy]

27.4 ng/ml