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Newbie: Treatment Decisions and Pet Scan PYLARIFY PMSA

frankie08033 profile image
13 Replies

Just received the news about my PC? PSA 5,3, Gleason score 8 ( 3+5). Biopsy took 14 cores and 7 show cancer.

I’m 66 in very good health except the PC.

Father died of PC in 1987 so there’s family history.

Looking at both radiation and surgery at 2 places. One here in Richmond, VA and other at Penn Med in Philadelphia. Not sure which way or where to go yet, still gathering information on both treatments. Will go to Penn this week to discuss RT. Daunting task!!!

Surgeon in Richmond wants to do a PMSA before surgery but Penn Dr does not do that first. He would take out Prostrate and then biopsy to see if any spread, then PMSA if needed.

I like the idea of going to bigger teaching hospital for treatment and familiar with Penn Med as our son was treated at CHOP for Cancer years ago, successfully, l’ll add.

However really like the thought of getting the scan in Richmond, before surgery already approved so not much cost.

Thanks for any input.

frankie08033

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13 Replies
Tall_Allen profile image
Tall_Allen

Because you are in the "high risk" category, I think it is a good idea to get a PSMA PET scan to rule out distant metastases before any therapy. It will probably be negative, but possibly could spare you an unnecessary procedure.

Can you go to Georgetown? I think Sean Collins, who does SBRT there is excellent.

Take your time. Even high risk PCa grows slowly, so you have months to make a decision.

LowT profile image
LowT in reply to Tall_Allen

Good advice.

frankie08033 profile image
frankie08033 in reply to Tall_Allen

Thanks for your reply. Will check out GT.

frankie08033 profile image
frankie08033 in reply to Tall_Allen

d I hear you have a website and is it available or is it just here in the HU network?

Di

Tall_Allen profile image
Tall_Allen in reply to frankie08033

I write articles on prostatecancer.news that allows comments. I am usually here.

frankie08033 profile image
frankie08033 in reply to Tall_Allen

Thank you. Get my Pet Scan tomorrow and should have results in a few days.

Justfor_ profile image
Justfor_

Definitely PSMA PET scan before any treatment. Then choose surgeon, if finally going the RP path, based on number of procedures each one has done in the past.

Murk profile image
Murk

A negative PMSA test means very little since it doesn't detect all initial spreads. Whatever path you decide and Whoever you choose, just make sure they have done thousands. There are a lot of good doctors and facilities between DC, Baltimore and Philly.

JWS13 profile image
JWS13

I would absolutely do the PSMA Pet before you have the RT to make sure all "targets " are apparent!...whatever it takes...you got "one"{ main shot at this...you don't want repeats!

I wouldn't be in such a rush to get RP surgery. It is the first thing a urologist will suggest as that surgery is what they do. There are other less invasive options. Do your homework.

esperandrich profile image
esperandrich

I was 4x4 gleason in two of twelve cores. You might want to look at the Ascend RT trial and buy the book The Keys to Prostate Cancer by Dr. Mark Scholz. It is like 12 bucks on Amazon. Also, Tall Allen has good info on his website.

Bkraus1 profile image
Bkraus1

I would pursue the PSMA scan. You are in a high risk category. If the scan shows lymph node involvement than that would change your radiation field and may change your opinion for having any surgery. The PSMA scan will help you define the cancer and will be more selective for treatments. Hopefully the scan is negative, best wishes.

frankie08033 profile image
frankie08033

thanks for all the input. Getting a PSMA today at university of Penn Med. Should have results in a day or 2. Still torn over treatment path, RALP or RT. The RT would be HDBT,, 5. 1/2 weeks rt and 2 years ADT.

At some point you just make best decision you can and deal with future when it happens.

Anyone have an experience at PennMed?

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