Severe coronary atherosclerosis and ADT

[spencoid2]

My recent PET / CT scan mentions severe coronary atherosclerosis. Previous one only said The heart is normal in size with scattered coronary artery calcifications. Also the new PET ? CT said something about heart enlargement but the last one said size normal. Previous scans also said there was an enlarged descending aorta not big enough to worry about now but close. I forget the cutoff typically used.

Is this stuff just not that accurate? I have a good dicom viewer that lets me see 3d and has all sorts of controls over contrast opacity depth of focus etc etc and I can not see any of this cardiac stuff.

The viewer is called 3dicom, comes from OZ and is about $40 a year. Fun to look at but not being a radiologist ???

Finally the big question. My pc is or at lest is partly castrate resistant. Would it be possible to get some testosterone to hopefully mitigate these side effects of no T? Not taking secondary ADT stuff just orchiectomy but my T is very very low .1 ng per deciliter not milliliter, deciliter translates to .001 ng per milliliter

[MateoBeach]

You are treating your scans? You have coronary artery disease (per the calcifications) so you need to address that risk. That means the maximum tolerated dose of a statin, to a LDLc or ApoB level of under 60-70. PCSK9 inhibitor if the statin doesn't get you there. Optimal BP control under 130/80. Consider low dose aspirin if you are not a bleeding risk. A stress echocardiogram from a cardiologist would be a good way to evaluate and then manage. And substantial cardiovascular exercise in addition to strength of course.

Testosterone would completely nullify your orchiectomy. Would only consider a carefully engaged and monitored trial of BAT if you so choose. Otherwise you should also be on an ARSI drug. Firmagon or Orgovyx probably best from CV risk viewpoint.

[j-o-h-n in reply to MateoBeach]

I say again............ you are an ace from our deck............

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/10/2023 7:57 PM EST

[spencoid2 in reply to j-o-h-n]

and you are the joker

[j-o-h-n in reply to spencoid2]

Thanks..... and when I was young I was known as the pokeherjoker ........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/10/2023 10:26 PM EST

[Hidden in reply to j-o-h-n]

Liquor in the front, poker in the rear.😜

[j-o-h-n in reply to Hidden]

Good one..... thanks............ wrote that one down for a toast at the festive Church's Christmas dinner. My old toast used to be "To all the kisses I have snatched and vice versa".,

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/11/2023 2:58 PM EST - Honor our Veterans.

[spencoid2]

i see my primary on monday and will ask her to refer me to a cardiologist thanks for the recommendation i was surprised that my ct scan went from scattered to severe athro

[j-o-h-n]

YOUR POST GOT POOFED...... Don't fret, it happens to the best of us...

Good Luck, Good Health and Good Health.

j-o-h-n Saturday 11/11/2023 2:18 PM DST - Honor our Veterans.

[Hidden]

Kaiser sent me to UCLA for a CT with contrast to confirm no internal blood loss. Have anemia.

The UCLA radiologist came back with a "major" thrombus in my descending aorta, and 2 ribs that never healed.

I had the Chief of radiology at my Kaiser hospital read the CT, and stated some "minor athescreloris" and 2 ribs that have evidence of past fractures. We had an X-ray confirm that. They healed, but incorrectly set.

So, some people just dont know how to read a CT.

[spencoid2 in reply to Hidden]

i certainly don't i can't even find my heart

[spencoid2]

thanks i'll ask her