No Longer Undetectable, PSMA-CT Results

[DesertDaisy]

I posted a few days ago about the fact that my husband had been undetectable since his prostate was removed in April of 2021. And then on 3/31 his PSA was 6.3 and on 4/03 it was 7.1.

The oncologist ordered a PSMA-CT scan and that was done today. The oncologist's PA called us with the results and she felt that the results weren't horrible. She said that there were some lymph nodes near the abdomen and a kidney that appear to be cancerous, but nothing else indicated. The report also indicates an avid lymph node in the supraclavicular region. The bones and other organs are clear. Here is a portion of the report that mentions the tracer avid lesions. I will admit that I don't know what the max SUV means.

Pelvic and abdominal lymph nodes: Several adjacent the right retrocrural tiny tracer avid lymph

nodes measuring up to 1 x 0.7 cm with max SUV of 6.2 seen on image 190.

Tracer avid left para-aortic lymph node measuring 1.3 x 0.6 cm with max SUV of 20.1 cm on image 213.

Additional tracer avid left para-aortic lymph node measuring 0.5 x 0.5 cm with max SUV of 10.6 seen

on image 230.

Bones: No tracer avid lesions. No suspicious lytic or blastic lesions. Age-appropriate DJD and DDD.

Lines/Tubes/Devices: None.

Head and Neck: Tiny tracer avid lymph node at the left supraclavicular region with max SUV of 2.9

seen on image 105.

She spoke with the oncologist and the plan is to start my husband on Casodex and Eligard. I was hoping that radiation would be an option, but since there are lymph nodes beyond the prostate bed I'm assuming that won't be an option.

They have also sent tissue removed during the surgery for somatic testing with Tempus.

This is all the information I have now.

[maggiedrum]

My one PSMA-PET/CT scan results were very, very, similar to yours. It was explained to me that it does not make sense, in that it wouldn't be effective, to irradiate so many locations when the PCa is most (i.e. almost 100%) likely already in various other locations including other lymph nodes, not yet detectable. And surgery is not an option for the same reason. So systematic drug therapy, chemo and/or hormone, would be the SOC. Good luck.

[Justfor_]

From undetectable non-stop to 6.3, how come this? Did your doc tell you that silly SoC has it quarterly PSA the first year and semi annually afterwards. I have similar staging like your husband, apart from N0, and for almost 4 years now I take monthly PSA tests, sometimes earlier if some reading isn't as anticipated.

[DesertDaisy in reply to Justfor_]

He went from undetectable to a 6.3 in 4 months. The doctor suggested he go 6 months and we declined, but agreed to going 4 months because he had been undetectable for 2 years. So in 4 months he went from undetectable to 6.3. Such a rise in a 4 month surprised me also.

[Justfor_]

Sorry to hear this. You can't be too careful with this sneaky disease. Best of luck with his treatment.