Should I take Nubeqa continuously when going to a PSMA Pylarify PET scan or take an intermittent break for a few weeks beforehand?

[GeorgeGlass]

Should I take Nubeqa continuously when going to a PSMA Pylarify PET scan or break from the Nubeqa for a few weeks beforehand?When getting a PSMA PET scan, I often here advice about temporarily pausing use of whatever drugs that are effectively keeping the PSA scores down at nadir or below .1. The purpose being to see where the cancer is when it's not being suppressed by the ADT.Does this technique apply to Nubeqa, and the other 2nd line ADT drugs like Zytiga, Xtandi etc?George

[Tall_Allen]

Xtandi increases PSMA expression for a while. Maybe the same is true for Nubeqa?

[GeorgeGlass in reply to Tall_Allen]

So it's recommended to stay on it, and do not take a break prior to the scans?

[cesanon in reply to GeorgeGlass]

What is your doc saying?

It sounds very counterintuitive to me. Even TA is uncertain.

Maybe your Doc. Is uncertain. But he doesn't get to not have a recommendation one way or the other.

[NanoMRI]

In all my patient detective and research efforts IMO there is insufficient and unclear data as whether ADT (various) increases or perhaps masks effectiveness (how does one recruit patients for a substantial enough trial).

What I did experience over six years ago was that a Ga 68 was 'clear' at 0.11 while the Ferrotran nanoparticle MRI identified five suspicious pelvic lymph nodes; six confirmed by salvage lymph node surgery I share about.

Post my salvage ePLND I have had three PSMAs, first two clear and this current one, as shared in post, a suspicious lesion on liver. If this current one had been 'clear' I would have made a decision as to whether I wanted a fluciclovine or Choline PET for comparison. When I feel I have conclusive finding with this current imaging I will reconsider comparative imaging and really wish the Ferrotran was available - maybe later this year in Europe.

[Wagon-Wheel in reply to NanoMRI]

Is the Ferrotran scan only available in Europe?

[NanoMRI in reply to Wagon-Wheel]

Great profile name! As I understand, very limited availability at this time in Germany only, final trials and bureaucracy hurdles. I would be there now if I 'qualified' - shame over six years since mine and can't get it. You can follow here: splmed.com

[Mikes21 in reply to NanoMRI]

Did you figure out the liver lesion? I have a less than one inch lesion shown on a ct but didn’t light up for the pet ct or psma so I’m assuming not cancerous and will get an ultrasound on it. Thx

[Seasid in reply to Mikes21]

Did you do the fdg pet scan?

[Mikes21 in reply to Seasid]

I did the one where they injected radioactive liquid into me and they called it a pet Ct

[Seasid in reply to Mikes21]

I understand. That is actually funny how these people are very relaxed and not very precise. We don't really know but my assumption is that that was probably the FDG pet ct scan. My RO also called it simply pet scan, but we don't really know. Most probably it was an FDG pet scan.

[Mikes21 in reply to Seasid]

Yes fdg. Is that a good one for liver to rule out cancer? They want me to ultrasound now. Psma didn’t light up either

[Seasid in reply to Mikes21]

Yes, the FDG PET/CT scan is the most common type used for detecting cancer, including in the liver. FDG (fluorodeoxyglucose) is a radioactive glucose analog that is taken up by cells with high metabolic activity, such as cancer cells. The PET component of the FDG PET/CT scan detects this radioactivity, highlighting areas where cancer may be present. The CT part provides detailed anatomical information, allowing for accurate localization and assessment of potential tumors.

[Mikes21 in reply to Seasid]

Thanks I’m hoping it’s just a fatty liver lesion then. Think that’s possible and then I guess monitor to see if it needs removal?

[Seasid in reply to Mikes21]

I believe that my sister said that we all with cancers have a fatty liver. I have it on the ultrasound, my sister has it on the ultrasound and probably you also have it on the ultrasound. The interesting thing is that my liver fibroscan was actually good. That is like a biopsy. I suggest that you also ask for a liver fibroscan after the abdominal ultrasound so you know the expected of the damage to your liver.

[Seasid in reply to Mikes21]

I suggest that you also download the ChatGPT application. It is very useful for us because we don't really know everything and we don't have a medical degree and a high level of knowledge. The artificial intelligence still know much more than us. The only downside is that they can also make mistakes but usually they are correct but always double check everything with your appropriate specialist.

[NanoMRI in reply to Mikes21]

Of course will be doing further investigation but I am accepting this may be prostate cancer progression needing treatment. I am staring a new post to share findings from GUARDANT360 liquid blood biopsy and Pylarify imaging at 0.033.

[SViking]

I am currently on enzalutimide mono therapy with rising PSA so I need a new PSMA scan. I want to begin the BAT trial but to qualify MO says I must go back on Orgovyx and show a rise in PSA. I wanted to speed things up and start back on Orgovyx now but RO and MO said to wait until after the PSMA scan.