Anyone have an opinion on this issue as I prepare to see a MO?

[PARKER3237]

Could the PET/CT SCAN have read the high glucose in my system as met pelvic lymph nodes and met bone?

Just asking since I was looking over my medical records for the last 10 years and the calcium number has always been in the mid-range, but the glucose has always been very high. (I am a type 2 diabetic). I am only asking as I have never exhibited any cancer symptoms any time and it was only because of the PSA level at my last primary doctor's visit I suggested about seeing a urologist.

I know that the flotufolastat F 18 gallium causes the hot spots on the PET/CT Scan and is drawn to any cells that are active with cancer or glucose and insulin.

Is there another test that should be done before starting or suggesting a treatment plan?

[NanoMRI]

I find comparative imaging, second opinions on the imaging and blood biopsy testing critical to my treatment decision making.

[Justfor_]

You may counter check with another radioligant. My preference list:

1) PSMA 2007 - not available in the USA

2) Gallium 68 labeled PSMA - the oldest and most realized around the globe exept for the USA

3) Pylarify - preferred in the USA

[Tall_Allen]

You are confusing different types of PET scans. The flotufolastat F 18 gallium (Posluma) PET scan you had detects PSMA, not glucose. It is an entirely different PET indicator, fluorodeoxyglucose (FDG), that detects glucose metabolism.

[PARKER3237 in reply to Tall_Allen]

Thanks. I was just asking because at the time of the scan a few weeks ago, it was mentioned in the instructions that any insulin could trigger errors if the BS was up in numbers. It mentioned that glucose could absorb the radioactive particles to make it look like hot zones.

[Still_in_shock in reply to PARKER3237]

Ive seen those too in "instructions" It doesnt apply to PSMA/PET scans.

Ive even had a "tech" tell me I need to reschedule fie to high blood glucose.

[Tall_Allen in reply to PARKER3237]

Although seldom used for PCa, FDG are the most prevalent PET scans, so the instructions are written for them. They just forgot to cross that out for you.

[PARKER3237 in reply to Tall_Allen]

That's okay. I trust Baylor. One of the better cancer hospitals.

[Ian99 in reply to Tall_Allen]

When assessing the viability of Pluvicto for treatment... am I right to assume that for PCa, FDG scans are mostly used to assess concordance or discordance relative to PSMA avid cancer cells ? I haven’t seen this mentioned in a while so am wondering if it is still current.

[Tall_Allen in reply to Ian99]

Yes. It hasn't changed. It isn't required, but it's prudent, IMO.

prostatecancer.news/2019/12...

[maley2711]

You were given an answer, which you then reject. Why did you ask then?

Simply rely on Baylor's advice...and evidently they believe you are metastatic?

[LongevityAT in reply to maley2711]

I hope most on here have come a long way in terms of automatically accepting the thinking of their doctors. Time and again we hear stories on HU of two doctors giving different treatment advice to the same patient. I applaud second opinions, independent research and of course, dipping into the collective wisdom of this group.

[maley2711 in reply to LongevityAT]

I agree.

[PARKER3237 in reply to maley2711]

You missed the point. I sought out some answers and merely made a statement. Enough said. Cannot made a definitive answer without researching and seeking advice from others.

[maley2711 in reply to PARKER3237]

quite often, there is no definitive answer, as of course you know.

[NecessarilySo]

I believe radiologists can make mistakes. Try to feel pain in the areas of suspected metastases.

[Cooolone]

Apples & Oranges!

Check the scan/test report for the contrast used, actual type of test, then let Dr. Google be your friend to define what is imaged and made avid by the agent/scan.

You are confusing things, let alone the "association" of glucose with PCa, as there is none, with the exception of a very small cohort of very advanced late stage patients.

Good Luck!