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PSMA PET/CT Scan

Aunelaman3fac17
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I have stage 4 metastatic prostate cancer and have recently completed 10 cycles of chemotherapy. I have concerns because my oncologist and health trust will not use PSMA PET/CT scan for staging and monitoring of any progression of my cancer. Using only bone scans and ordinary CT Scans instead. I don’t understand this as the trust has PET/CT scan facilities and based on the reports I have seen the bone scan and ordinary CT scan are not giving clear or conclusive results. I know from my experience of treatment in another country that PSMA PET/CT scans give much more detailed results and I don’t understand why this scan is not used in my case? I’ve also not had an adequate explanation from my oncologist why. Is there anything I can do about this? 

Regards

Alan

  • Hello aunelaman3fac17,

     

    Thanks for getting in touch and welcome to the online community. My name is Karen and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.  

     

    I’m sorry to hear of your prostate cancer diagnosis, I hope that you are starting to recover and feel better after your chemotherapy treatments.

     

    It must be frustrating for you that your oncologist has not given you an adequate explanation about why the Positron Emission Tomography (PSMA) PET/CT scan is not being used for the monitoring of any progression of your cancer. It’s natural that you are concerned about this as you say the bone scans and CT scans are not giving clear or conclusive results. You say you have experience of treatment in another country that PSMA PET/CT scans give more detailed results.

     

    We can’t comment on healthcare practices in other countries, as we are a UK cancer charity, however the following information may shed some light on why you have not been offered a PSMA PET/CT scan in the UK.

     

    In the UK the National Institute for Health and Care Excellence (NICE) produces recommendations and guidelines for the treatment and surveillance of cancers, including the use of diagnostics and medical technologies.

     

    This report from NICE in 2023 shows decisions taken regarding the use of isotope bone scans and PSMA PET/CT scans for prostate cancer after looking at the evidence. It states: -

     

    ‘A survey of topic experts suggests that the current recommendations are appropriate and align with current practice. Although there is a suggestion to change the 'strength' of the recommendation from 'offer' to 'consider' isotope bone scans in asymptomatic people who are at high risk of developing bone complications but are undergoing 'watchful waiting' instead of hormonal therapy (recommendation 1.2.17), there is no evidence to support a change at this time. We will continue monitoring the evidence base for new technologies such as gallium-68-PSMA-PET-CT and other PET-CT scans.’

     

    If you are having your treatment in England, I have found this statement from NHS England in 2025 about the use of PSMA PET/CT scans, the inclusion criteria relate to patients who are at high risk of primary disease suitable for radical curative treatment and those with biochemical recurrence suitable for salvage therapy.

     

    As we don’t have access to your medical records it’s difficult to say for sure if a PSMA PET/CT scan should be considered for your individual situation.

     

    We would encourage you to raise your concerns again with your oncologist or clinical nurse specialist to gain further clarity and understanding for you personally. You also may wish to consider getting a second opinion.

     

    Prostate cancer UK has a support line and they may be able to provide additional information and support. You may also wish to consider looking at the Macmillan online prostate cancer forum to share experiences with others who have a similar diagnosis and situation.

     

    You may also wish to consider giving one of our nurses a call on the support line. We are always here you.

     

    Best wishes

     

    Karen, Cancer Information Nurse Specialist 

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

    Ref/Khe/KG

     

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