My MO yesterday said to wait to see if my psa rises before another PSMA PET or ADT.She thinks my immune system is keeping it at bay; did not double in a year, and is now 0.58. Neither mri or psma scans showed anything.
Should I get second opinion at Mayo and can their choline c11 pickup things that others don't?
I write this in the waiting group room for my 5/6 intervesical treatments for bladder.
C11 Choline PET rarely picks up anything PSMA PET doesn't, but Mayo likes to sell patients on it. Your MO's advice sounds good to me.
Thank you. That is what my S.O. said, who is a nuclear tech in cardiology.
Mayo rotates c11 with two psma scans. Best of both worlds
"Best" for Mayo's bottom line. NaF18 PET scans find twice as many bone metastases as PSMA PET scans.
Never hurts to ask.
I believe the Choline PET is more geared towards picking up non-PSMA sensitive abnormalities and clinics outside Mayo may use FDG PET I've been told. If you've never had anything picked up by PSMA and at your current PSA level, I like your MO's advice, other than curing your "worry factor", and I get that!
Question: Should I get second opinion at Mayo and can their choline c11 pickup things that others don't?
There's two answers to your question(s) in your UserId. They are NO n NO.
Good Luck, Good Health and Good Humor.
j-o-h-n
My intentions are to do all I can to stay ahead of this beast, to not give it time and obscurity. At 0.5 post RP I would certainly be getting comparative imaging, which the Mayo indeed supports. My first Ga68 PSMA missed six cancerous pelvic lymph nodes, which were picked up by another imaging method; validating comparative imaging. Subsequent Ga68 and Pylarify have been 'clear' for PC. I have FDG coming up - this is principally for my metastatic melanoma. My next imaging for PC will be C11 Choline.
Prior to PSMA scans in this country, the Choline scan at Mayo was one of the few scans available in the US. Now that PSMA is widely available, the choline san is used much less. Mayo says that their choline scan can pick up lesions that the PSMA scan does not, especially if those lesions are non PSMA sensitive.
In theory yes and does happen. C-11 Choline identified lesions in me unrelated to PCA. It can do that but doesn't always. I now do what "NanoMRI" does and have for some time. Pylarify for PCA, FDG for my other cancer. My MO is also of the opinion that there's no added benefit getting any more C-11 Choline tests.
Not to turn this into an insurance thing, but guessing there has to be medically necessary to get a Choline scan in addition to any other scans. Not sure how anyone can make the case for that with other less costly options available. But that's not the question being asked.
I had what I consider false positives from a Choline 11. Seems like it sees inflammation more. I would avoid it unless you become convinced your PCa is not PSMA expressing cancer. Which would only be in a small percentage of cases.
Do you mean, a Choline 11 may be beneficial for PC patients expressing an always historically low PSA reading (under 4) but have PC anyway ? Thanks !!
Yes. It was 4.6 before prostatectomy. After it was 0.2, then 0.3, before and after radiation.
PSMA PET required for LU PSMA therapy?
Baseline PSMA-Pet scan?
Choline PET scan
PSMA PET-CT Ga68 Scan results
