Rx metastatic in November 22 psma pet scan in August 23 showing no mets

[Richieis1]

I am looking for some help understanding this and next step

[Tall_Allen]

Of course it showed no metastases- you are on ADT. It was a useless scan. Continue with your hormonal therapy - it's too late for triplet.

[Richieis1 in reply to Tall_Allen]

Oncologist wants to do radiation to prostate,what are your thoughts on this

[Richieis1 in reply to Richieis1]

I am really struggling with hormone therapy

[Tall_Allen in reply to Tall_Allen]

How many bone metastases were diagnosed?

[Richieis1 in reply to Tall_Allen]

One four cm in my hip.

[Tall_Allen in reply to Richieis1]

Then prostate radiation is a good idea.

[Ingress in reply to Tall_Allen]

Why is it too late for triplet?

[Tall_Allen in reply to Ingress]

Triplet only works if used from the start. Chemo only acts on rapidly growing cancer.

[Ingress in reply to Tall_Allen]

Not what both of my MO’s said but ok.

[Tall_Allen in reply to Ingress]

If they don't know that chemo only acts on rapidly dividing cells, you need new MOs. Triplet has to be used at the start or not at all, or at least not until CRPC. When chemo or advanced hormone therapy is used as monotherapy, protective mechanisms (like cellular senescence) kick in soon afterward. It protects the cancer cells from destruction by the other medicine. They have to be used together or wait until the first drug stops working.

[Ingress in reply to Tall_Allen]

That makes more sense than it has to be right away or not at all. Thankfully, I am not CRPC, yet. Guess I will see if anything has change after my scan on Thursday.

[RCOG2000 in reply to Tall_Allen]

I don’t understand the comment that this is a useless scam. It was a PSMA scan I am in a similar situation at the moment.

[Tall_Allen in reply to RCOG2000]

PSMA is PSA-dependent - it isn't useful when PSA is under 0.5.

[Richieis1 in reply to Tall_Allen]

My psa never went below 1.3 and is slowly creeping up

[Tall_Allen in reply to Richieis1]

Then you should be amplifying hormone therapy with Nubeqa, Erleada or Xtandi.

[GP24]

I think your oncologist recommends radiation based on this study: esmo.org/newsroom/press-rel... This radiation will make you live longer but will not avoid ADT.

[j-o-h-n]

If he wants to burn your bed...... that's usual protocol.... so no worries but make sure Doc RAYgun knows what's s/he knows what s/he's doing.... I had 39 sessions......no issues at all then but later left urinary stent was found to be fried.....As the referee says to boxers before the fight "protect yourself at all times"........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/01/2023 2:06 PM DST

[Boywonder56]

They said that to me in catholic school.....while i stood there in boxers.......

[chips1942]

Your cancer may not be generating much PSMA . Often an FDG pet/Ct can more clearly show active PCa.