PSMA PET Scan????

I'm 4-3/4 years on ADT, MO has ordered NO Scans for 2 years even though I've complained of returning bone pain , groin pain, pain in ribs and spine, as well as thigh and pelvic pain. Also pre treatment cough has returned, (was diagnosed with lung mets as well as bone and lymph node).No scans have been ordered, and seems as though they are only monitoring my PSA levels, and will be "Reactionary" rather than "Proactive". Never a mention of ordering a PSMA PET scan. Why is that?

It was my General Practitioner who ordered the Dexa scan and x-rays that found the Osteopenia and vertebral fracture.

[witantric]

I would be proactive and seek a second opinion. Where are you based? Patients need to be proactive and aggressive in pursuing what is best for them.

[GP24]

I guess your MO thinks all he can do for you is to continue with the current meds. Then he does not need a PSMA PET/CT. If you want to radiate the metastases or get a Pluvicto therapy, you will need a PSMA PET/CT. Your MO cannot offer these therapies.

[Tall_Allen]

You are proactive in taking ADT and Zytiga.

PSMA PET scans are highly PSA sensitive, so it likely would not show anything anyway. It is also not FDA-approved for patients with mets unless there is a biochemical recurrence. However, given your history, I can see why you are anxious. Perhaps your MO may be more amenable to a full-body CT or an FDG PET/CT scan? You may have a kind of PCa that does not show up on a PSMA PET scan, and a change in therapy may be required.

[Cateydid]

I’d get another onc.

[Worked_the_World]

A PET scan does use a lot of extra radiation. Prostrate cancer treatment already uses heavy doses and adding more could be debatable.

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

I got so many scans......my family calls me "The grill".........(rare, medium or well done).....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 01/03/2024 7:04 PM EST

[treedown]

That sounds odd compared to my situation. I am going to CT and Bone scans this month, no PSMA because it would not change my treatment plan. I am waiting for either CR or progression on fore-mentioned scans. The plan has been to get scans every 6 months ish and sooner if I have pain. If I have pain and scans confirm a met I would radiate. Do you have a RO on your team?

[Worked_the_World]

RO is Resource Officer or Radiation Oncologist? In either case, yes.

[lowT163]

time to sign up with a big hospital. MRI still a great scan for prostate cancer with the right people reading it.

[lowT163]

If he can’t say I want a scan and get it there is a problem. Half of the problem with this disease is we know very little and scans is all we have. Psa is useless or it was in my case. If I would have had a PSMA scan at diagnosis there would be no problem. Didn’t know it existed. Here in 2017 it was still unapproved and no one even talked about it. I could have flown to you guys and had it removed and been fine.