psma findings

[Mikes21]

Haven’t heard from my Mo but I just opened the psma report and I don’t have any finding of metastasis. So I guess I run another psa? Monitor I guess? Anyway I’m happy for sure. I guess we will stay on top of it with psma and psas. Surprised my mo hasn’t called yet lol. She last said she was intrigued when I had the regular pet ct that didn’t light up so I wonder what she thinks now. Crazy I was <.006 in March and in June have .014 so I’ll still be vigilant going forward. Any guidance is always appreciated warrior brothers

[Tall_Allen]

PSMA PET/CT will probably not show anything until PSA reaches 0.5 - it is highly PSA dependent. IDK why you had a PET scan at such a low PSA, but the results are meaningless. Waiting is is a self-fulfilling prophecy - by the time PSA increases enough so that you will see something on a PSMA scan, you will reach an incurable stage.

I don't understand why you didn't have your pelvic lymph nodes irradiated, but if you want to cure your PCa, you need to get that done + 3 years of ADT +2 years of abiraterone.

[Mikes21 in reply to Tall_Allen]

Yeah I trusted what the mo said and the ro. So are you saying I can just spray the pelvic bed now and adt and pred and can be cured? Is there a particular order to start things out meaning radiate first? Would that be salvage radiation? I’m looking to consult with a new MO. Thanks TA

[Tall_Allen in reply to Mikes21]

I'm not guarateeing anything, but you only chance at a cure is salvage radiation of the entire pelvic lymph node area + 3 years of ADT + 2 years of abiraterone.

[Mikes21 in reply to Tall_Allen]

TA would I also do chemo? I’m only on trelstar at the moment. Could I get zytiga going now too?

[Tall_Allen in reply to Mikes21]

No chemo.

[NanoMRI]

I too am awaiting results on my latest PSMA, and also liquid blood biopsy. Because you asked for "any guidance" - I have very different views based on experiences. I too had RP - mine over eight years back. My nadir was 0.050 and we accepted cancer had spread beyond the prostate as I rely on <0.010 as best indicator. After my unsuccessful salvage RT at 0.11 I learned from docs in UK that they begin PSMA imaging post RP at 0.030 - yes 0.030. Yes, findings are rare but for the men that it does indicated suspicious sites, very useful.

As I share, after my salvage RT I wanted alternatives to pelvic irradiation, ADT and possibly chemo. I was recommended and accepted into the STAMPEDE trail - I declined.

Instead, when my uPSA was back up to 0.11, I went to Europe for Ga68 PSMA (I was declined acceptance into US trial) and 'better' Freetown nanoMRI. Not surprising, the Ga68 was clear while the nanoMRI identified five suspicious pelvic lymph nodes. Six were confirmed cancerous by salvage ePLND with frozen section pathology method, yielding a nadir of <0.01.

The PSMA imaging results I am waiting on are my third since my uPSA rose to 0.030 post ePLND. My diverse, multi country medical team supports imaging at this value in hope of finding something. Results, even when clear, are by no means meaningless to me and my team. Same with the liquid biopsy.

Hope this is helpful to you. All the best!

[Mikes21 in reply to NanoMRI]

I really appreciate the feedback. Thanks a bunch and hope your psma goes well too 🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻