PSMA PETCT

[Alinur]

friends,At what PSA level to have PSMA PETCT if your PSA doubling time is less than a month and beginning of CRPC.

PSA is 0.224 now.thanks.

[Justfor_]

At low PSA, PSADT (Doubling Time) is equally _if not more_ important than the PSA value itself. IMO you shouldn't delay it.

[Alinur]

Have you CRPC?Thanks

[GP24]

If you are CRPC you could follow this trial: pubmed.ncbi.nlm.nih.gov/377...

[Brightman]

I was told a psa of 0.2 would lead to a PSMA Pet Scan. My psa went from neglible to .27 to .41 to 1.68 so I had my first Pet scan a week ago . It picked up 2 small tumours which the radiation oncologist showed me yesterday and so different than when shown on a CT scan ( could hardly see them). They will Both be radiated using SBRT at the same time. Will have simulation for 2 hours on Monday , then radiated a week or so later for 3 sessions, so all will be finished by Christmas. I have had this done before on 2 other tumours. Just an ongoing process with metastatic disease it seems. Doctors are marvellous what they can do now. Good luck.

[Conlig1940 in reply to Brightman]

Has your SBRT Treatments been Monotherapy - i.e. No additional hormone etc treatments ?

[Brightman in reply to Conlig1940]

I have been on Hormone therapy since I was diagnosed in 2016 so for 8 years. I also had chemotherapy in 2016-2017. So neither have fully the controlled my PCa.

[Conlig1940 in reply to Brightman]

I will clarify my originnal question .

" After you were diagnosed with prostate cancer - Was your 1st and only treatment SBRT ". ?

AND WAS THE HORMONE & CHEMO ADDED LATER or At the same time as your SBRT Treatment ?

[Brightman in reply to Conlig1940]

My first treatment was Radiation of prostate, then Hormone therapy, then Chemotherapy, with my first SBRT 5 years later in 2021 on my T10 then another SBRT in 2023 on my 6th rib. TheT10 treatment led to a compression fracture in 2022, which destabilised other vertebrae leading to a fusion from T12 to T5 and L1 in May this year ( major surgery) which I am gradually getting over now. So now the PSMA PET scan has shown 2 more lesions on left hip and right 8th rib, which I am about to have more SBRT on. A long ongoing process unfortunately.

[Alinur]

Thank you everyone.

[EdBar]

My oncologist, Dr. Sartor uses 0.2 as the level at which to get a PSMA scan.

Ed

[Alinur in reply to EdBar]

Did they find anything at that low PSA?

[EdBar in reply to Alinur]

Yes, twice in the last two years they identified a tumor on two separate ribs that they were able to radiate with SBRT, after each treatment my PSA fell back to nearly undetectable. I’ve got the same thing going on again now, my PSA over the last few months has gone from 0.06 to 0.07 to 0.08 and the most recent was 0.11. So something is festering somewhere, my plan is the same, once it hits 0.2 I’ll opt for a scan and see what’s going on. Sartor agrees with this plan and said that I can play whack a mole indefinitely predicated by the number of tumors and location. I’m hoping to save other types of treatment for down the road if needed.

Ed

[Brightman in reply to EdBar]

We are only allowed to have 2 PSMA Pet scans in our lifetime in Australia before we pay fully. My radiation oncologist said that 3 tumours is the limit for SBRT. After that if there are more tumours, which he said would eventually happen, they then move onto other treatments. He also said that because all of my tumours have been restricted to boney areas, then that is a better sign for me.

[Cyclingrealtor in reply to Brightman]

What's the cost of a PSMA pet in Australia?

In the US PSMA's were about $1,000 when they were in trials and now that they are run through our healthcare system they start at about $5,000 and I have seen some guys posting that their insurance company has charged $25K - $35K.

[Brightman in reply to Cyclingrealtor]

$1235 for a PSMA-PET scan in Australia covered by Medicare for 2 in a lifetime.

[Seasid in reply to Brightman]

I don't see why you couldn't have more tumors radiated? Ok, 3 sounds reasonable but why would you limit the number that way?

[Brightman in reply to Seasid]

Not sure, but that was what the radiation oncologist said.

[Seasid in reply to Brightman]

Thanks, I believe that is something to do how much radiation could you get in total because radiation exposure adds up. Your RO have to calculate it. But probably 3 is a good informative number. You can always ask for a second opinion if it is important to you.

[6big]

I had a RARP in August 23 and my PSA started rising in Feb 24 and a PSMA PET scan wasn't done until mine reached 2.8 and Metastatic recurrence was found on right iliacs and 8th left rib

[Brightman in reply to 6big]

My recent PSMA Pet scan also showed a recurrence but on my 8 th right rib and my left liliac, the opposite of yours, but interesting.

[Teacherdude72]

Good question and doubling time is the key. I started a vacation from Lupron/Nubeqa Dec 2023 with a PSA of less than 0.02.Then: April 0.04, June 0.13, July 0.24 and then October 1.07.

I had the PSMA scan November 13th with the results finding no cancer in my prostate but on spot on L2 and a suspicious spot on a long standing cyst on one kidney.

The rapid increase, more than quadrupled, was the key to having the scan. PSA a week after the scan was 1.8. Back on former treatment immediately.

[Mike65g]

I would ask your oncologist. They know your case we don't.

[Mike65g in reply to Mike65g]

Since we don't have your my chart and are not your oncologist the replies you get here will not be accurate. You ask a pretty specific question. This forum won't get you an answer. Oh and please do not moderate this post.

[j-o-h-n in reply to Mike65g]

Greetings Mike65g,

Would you please be kind enough to update your bio. All info is voluntary and can help you and help us too. Thank you!!!

Good Luck, Good Health and Good Humor.

j-o-h-n

[dhccpa in reply to Mike65g]

I'm not sure I understand your objection to his question. I think he was asking what others are doing in the same situation. It seems that many, if not most posts on this forum deal with similar situations, although the specifics may be different. And it's a good way of seeing how your doctor's decisions compare with other doctors. But to each his own.

[Alinur in reply to Mike65g]

Please give details.I don't know to whom you talking.

[Teacherdude72]

I had mine after psa more than quadrupled in three months. was 0.24 then 1.07. Week after th PSMA it was 1.8.

[dans_journey]

I have had two PSMA PET scans. The first was on 30 November 2021, not long after the FDA approved it for use in the U.S. at UCLA and UCSF only in their initial approval.

My insurance wouldn't pay for it because my PSA was less than 1.0 ng/mL, so I paid $3,300 out of pocket for the scan when my PSA was 0.22 ng/mL. The scan was inconclusive. There were no "hot spots" that could guide the radiation oncologist for salvage radiation therapy.

My second PSMA PET scan was after the salvage radiation therapy failed on 31 January 2024 when my PSA was 0.37 ng/mL. It, too, was inconclusive at that PSA level.

While reading other comments, I've seen that some have been lucky and had the PSMA PET scan detect tumors at low (~0.2 ng/mL) PSA levels, but according to this study, that's more the exception than the norm. You can see from the chart that you have a much better chance of detecting something the closer your PSA gets to 1.0 ng/mL or above. Here's the full study:

pubmed.ncbi.nlm.nih.gov/309...

Good luck.

Bar graph showing detection rate of PSMA PET scans at various PSA levels.

[Tall_Allen]

Have it now.