Question, each month with rising PSA, when do I do a pet scan

[Shorehousejam]

Medical Oncologist suggested waiting for the next two months to see if it’s still rising…

Diagnosed 06/2022

Gleason 8/9 Oligo metastatic 3 lytic lesions two resolved

Started Firmagon 7/6/2022

Zytiga with Prednisone 7/20/2022 currently still on these meds

Docetaxel Chemotherapy on 08/11/2022

End Docetaxel Chemotherapy on 12/23//2022

Completed 6 cycles @ 21 Days

Had Davinci Radical Prostatectomy with Lymph Node Removal on 03/14/2023

Only 8 Lymph Nodes Removed, according to operating urologist surgeon that is what he saw to remove

Germline; BLM missing a copy

Genome: Tier 1 ATM Frameshift Alteration

Mass on prostate bed I haven’t radiated as medical oncologist thinks it’s better to treat with systemic therapy. I believe this is causing my PSA to rise.

I prefer to radiate, as I finally have my colitis under control with no more bleeding, it’s been a long road with that issue since last July

What number PSA do I wait to before getting a pet scan?

Jan 4, 2024

0.46ng/mL

<=3.99 ng/mL

Dec 7, 2023

0.29ng/mL

<=3.99 ng/mL

Nov 7, 2023

0.11ng/mL

<=3.99 ng/mL

Oct 10, 2023

0.09ng/mL

<=3.99 ng/mL

Sep 7, 2023

<0.06ng/mL

<=3.99 ng/mL

[cesanon]

Two to three months sounds right to me. Maybe even a bit longer.

You still have prostate tissue left. It is going to generate PSA. You will never stabilize at 0.00 PSA.

The issue is: if the trajectory does start to asymptotically increase, what are the options to select from.

While you are waiting and watching, now would be a good time to fly around and get some second opinions on what your treatment options will be in that case.

[Shorehousejam in reply to cesanon]

My medical oncologist keeps mentioning Lu 177, I’m not real comfortable with it as I seen men exploded with metastases with mutation loads, to me it doesn’t seem to work

[cesanon in reply to Shorehousejam]

See my post to your other question.

There are solutions to that problem.

[mperloe]

Have they discussed whether Lu177 is an option?

[Tall_Allen]

What treatment decision do you need it for?

[Shorehousejam in reply to Tall_Allen]

well medical Oncologist mentioned doing a pet scan in a month or two because of rising psa

As above my last psa was Jan 4, 2024

0.46ng/mL

<=3.99 ng/m

[Tall_Allen in reply to Shorehousejam]

What treatment decision do you need it for?

[Shorehousejam]

Medical Oncologist keeps mentioning pluvicto, I’m not interested in that yet at all

[MoonRocket in reply to Shorehousejam]

I wonder if your MO is thinking along the lines of the ENZI-P trial. Did he discuss switching to Xtandi?

[ron_bucher]

Personally I've benefited from having a second medical oncologist on my team.

[Shorehousejam in reply to ron_bucher]

I did find a second one who spoke to my first main medical Oncologist and is mimicking him, this was after I clearly told him I wanted independent treatment. It stinks

[ron_bucher in reply to Shorehousejam]

I travel 400+ miles to visit a second opinion MO who has done nothing but prostate cancer for 30 years.