Axumin

[Yacky]

After radiation in 2017 my PSA has risen to 1.3 and my urologist is considering an Axumin Pet Scan. I also had radiation for laryngeal lesion about a year ago. My concern is more radiation and what it does to my immune system. Reading about nadar confuses me and I don’t want to overtreat. I have problems with mouth and tongue sores which my Primary Doctor says is an indication of a weakened immune system.

[Hidden]

Depending on whether recurrence is localized there are some non-radiation options, though I can’t say whether they are covered by insurance. The Axumin scan or PSMA if you can get it should narrow that down. Of course thr scans themselves use radioactive tracers but in very small amounts. Disclosure: don’t take my suggestions too seriously. I am not even close to your doctor’s knowledge,

na01.safelinks.protection.o...

[Tall_Allen]

Radiation of the prostate improves the immune response:

prostatecancer.news/2016/08...

What are your various white blood cell counts?

You should definitely have the Axumin PET scan, although your insurance may insist upon nadir+2.

If it is just a local recurrence, focal brachytherapy may be curative:

prostatecancer.news/2017/09...

If there are distant metastases, you can prolong survival considerably with systemic therapy. The Axumin scan will point you in the right direction.

[Yacky in reply to Tall_Allen]

Thank you.

[hwrjr]

No one else asked this obvious question so I guess I missed something in your post or there's more to the story than I know.

I assume you had radiation as the primary treatment for PCa. If you did, I dont understand how a PSA of 1.3 would trigger scans. Your PSA would have to be 2.0 + your nadir to trigger scans or any medical intervention. Most RO's would prescribe antibiotics and have your PSA retested in a few months.

[Yacky in reply to hwrjr]

Yes, radiation in 2017. Urologist concerned because PSA has gone up the last 4 times. He wants another PSA in three months. I had never heard if the Axumin and that’s what led to my post. I do not want to be over treated.

[hwrjr in reply to Yacky]

Interesting. I suppose it depends on the RO's definition of BCF. Another member posted recently that his PSA had reached ~1.6 in 2020. He received radiation treatment 14 years ago and after reaching a nadir of 0.6 several years ago his PSA has increased in the past 5 consecutive years. His RO doesnt't think he needs follow-up yet as his PSA has not yet reached 2.0+nadir, the Phoenix definition of BCF. I asked Tall Allen about the old ASTRO definition of BCF being 3 consecutive increases after reaching nadir and he said it hasnt been used since 2005. It sounds like your RO is being conservative which may not be a bad thing. It does call into question insurance coverage for scans though.