Hello, please see my bio for my dad's history. Below are the results from his recent pylarify scan. Does the "active metastatic disease" indicate that the xtandi/talzenna combination is no longer working or could it still be working in part? The answer may not be that simple but I was just looking for any input prior to his next oncologist visit. Thank you and Merry Christmas/Happy Holidays to all.
IMPRESSION:
1. Increased uptake about the right aspect of the prostate gland likely representing the patient's primary malignancy.
2. Extensive sclerotic metastasis throughout the axial and appendicular spine, the majority of which demonstrate no increased uptake. Sclerotic lesions with increased uptake present of the T11-L2 vertebral bodies, right clavicle and scapula, sacrum, right iliac bone, and right femur compatible with active metastatic disease.
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Juju0713
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Yes, here is the rest of the report. Thank you for your response.
FINDINGS: Normal physiologic activity within the lacrimal glands, salivary glands, solid organs of the upper abdomen, bowel, and genitourinary system.
No suspicious activity within the neck, chest, abdomen, or pelvis to suggest metastatic disease. Increased radiotracer uptake present about the right aspect of the prostate gland with maximal SUV 12.1.
Multiple sclerotic lesions present throughout the axial and appendicular skeleton compatible with treated metastatic disease. Sclerotic focus present about the distal right clavicle with maximal SUV 5.8. Multiple small sclerotic foci present in the right scapulawithout increased activity. Sclerotic lesions present T11-L2 vertebral bodies with maximal SUV 7.8. Increased uptake present within L5 sclerotic lesion of maximal SUV 6.7. Sclerotic lesions of the S1 vertebral body with maximal SUV 8.8. Sclerotic focus with increased uptake present the right iliac bone, maximal SUV 7.8. Sclerotic lesion of the proximal right femur with maximal SUV 8.0. Sclerotic lesion present of the right femoral diaphysis maximal SUV 9.4. No pathologic fractures are appreciated.
Thoracic aorta and heart are normal in size. The lungs are clear. No noncalcified pulmonary nodules identified. Solid organs of the upper abdomen appear normal. Right nephroureteral stent noted without hydronephrosis. Small bowel loops and colon are normal in caliber without obstruction. No ascites or free air.
It appears that whatever you have done has worked well. Metastatic activity is low. It hasn't disappeared entirely, but it is low. Your oncologist may think it is too soon to give up on Xtandi+talzenna, as long as your SEs are tolerable.
I have nothing specific to add to the navigation you’re getting from MoonRocket and TallAllen, and John. These are good, caring men, and the advice is solid. We are all lucky to be able to share it with each other.
Your Jan 3 date should be helpful. Agree that he seems to be getting good care, most importantly from you. It’s certainly possible that the doctor is invested in staying with the current treatment.
For now, but make sure to ask every question. Sometimes I used to take a printed page and just hand it to the doc to read first when he comes in if I have a lot of them.
There are many more good options for him. Have a beautiful holiday and great luck to you both!
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