Hi everyone,
For those who have been following my dad was diagnosed with PCa on Jan 18th, PI-RADS 5, Gleason 8, PSA 10.4.
He started 50mg of Casodex on March 8, and had Eligard 30mg injection March 26th.
He has had bone scan (nothing notable), CT (nothing notable), MRI showed one of his pelvic lymph nodes was lit up.
we just got back the PSMA PET and I am struggling to understand it, perhaps partially because I am a bit of a mess from what I do understand of the results (there are two liver spots).
My understanding is that metastasis liver from the start with no other metastasis (I.e bone) is rare. Can you help me understand the below? Any guidance (we are getting referral/second opinion to Princess Margaret)? Any places in the USA we can send our results for a second opinion online? Stories of hope? Clinical trials to look into?
PSMA PET Conclusions:
1. PSMA avid lesions within the right prostate extending from the apex to the base, also crossing midline consistent with malignancy (PSMA 3). There is PSMA evidence for extraprostatic extension into the anterior rectal wall on the right side as well as involvement of the right seminal vesicle and bladder wall on the right.
2. PSMA avid metastatic adenopathy involving the left external iliac and right prevesicular region (PSMA 2). Mild PSMA uptake noted within the small subcarinal/station 7 lymph node (PSMA 1), considered negative based on Promise criteria.
3. Liver metastasis involving segments 7, and 5/6 (PSMA 2). 2.9 cm focus within the subcapsular liver segment 7 (SUV max: 9.2, PSMA 2, Fused 146), and focal linear activity within subcapsular segment 5/6 extending over a craniocaudal length of approximately 4.2 cm (SUV max of 9.3, PSMA 2, fused 162).
4. No PSMA avid osseous disease.