PSA < 0.1 for five years after RALP then 0.23 at six-years and 0.40 at 6.5 years. PSA has remained at 0.40 for three months now.
PSMA/CT Scan early February 2025:
Conspicuous foci of PSMA uptake in the left deep pelvis likely associated with small nodes, suggesting locoregional nodal metastatic disease
No other PSMA avid lesions or nodes to suspect recurrence in the prostatectomy bed or additional metastatic disease
I cannot understand if that is a concern and wonder how the specialists will determine if the small 'deep pelvis' nodes are truly metastatic. My Decipher tumor report in August 2018 quoted a 4.2% chance of Metastatic Disease within 5-years.
The 2018 surgical pathology report for four lymph nodes were negative for metastatic carcinoma
BUT - much more interesting and probably more important was this finding in the Scan report:
Other Chest Findings: Severe degree of coronary artery plaque calcifications
Other: Mild degree of vascular calcifications
I had a coronary angiogram in June 2021 which found a 40% blockage of a coronary artery. The cardiologist determined a stent was not necessary. Since then I have had semi-annual EKG's and annual stress tests with radionucleotides which found only minor problems, which could be ignored for a while.
My cardiologist now wants to do another CT Scan with dyes specific to detecting artery obstructions.
Maybe the PSMA/CT Scan saved me for additional cardiac problems.
I see my urologist/oncologist February 20 to discuss the scan results.
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OldTiredSailor
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The agent used for the early February scan was F-18 PIFLUFOSTAT (PYLARIFY)
Posluma is flotufolastat F18 and seems to be specific to prostate cancer. Were you suggesting that for a better understanding of the deep pelvis nodes?
At this time I am more concerned about the coronary artery disease than the possible PCa metastasis. I have had some significant symptoms at times with very high BP in only my left arm while the right arm BP is 130/75. This has occurred many times with dizziness, fatigue, and confusion.
Does that seem wise?
The cardiologist did not tell me what agent she ordered but did talk about "contrast agent". My reading of the recent literature is that 18-F fluorodeoxyglucose (FDG) or 18F-sodium fluoride (NaF) are the standard agents/radio tracers used to detect arterial plaque and calcification.
The shocking and critically important July '24 PSMA/CT finding of mine turned out to be metastatic melanoma.
Seems you have ten years on me so perhaps why you are far more casual about your PSA numbers than I. But then, seven years ago, 61YO, at uPSA 0.113, I had six cancerous pelvic lumps nodes surgically removed.
If upcoming liquid blood biopsy and imaging results are further favorable findings, I plan to leave my medical team behind for some early spring sailing. All the best!
The radiologist noticed a lot of calcium in your coronary arteries on the PET /CT scan and mentioned it in his report. It was subjective and not quantified like a coronary artery calcium CT scan. Follow the advice of your cardiologist or you can get another cardiologist opinion. She apparently wants to do a CT of the coronary arteries with IV contrast, the type of contrast used for CT scans.
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PSMA PET 
Early use of LU-177?
Will Lupron and Casodex affect a PSMA PET Scan?
Is there a Psma blood test?
