Just finished HT

Good Morning Greener 

Just to comment on two points above (we have "spoken" earlier on another thread).

* Radiotherapy is confined to the Prostate unless there is evidence of Pelvic Lymph Node involvement in which case the lymph nodes will be "zapped" as well. (My MRI showed "possible lymph node contamination" so mine have been radiated!!

* A PSMA- PET scan is not given in most cases due to the cost to the NHS and the availability of the scanners. i understand the cost to be between £ 2600 - £ 3000 per scan 

I hope this helps.

Best wishes - Brian.

Just to add to my response to you on the 12 month on thread. You are possibly going to see a bounce in your PSA now that you have finished with HT so keep an eye on it and make sure that it is followed by a stabilisation or a drop. If you have 3 consecutive rises in a short period of time or it rises above 2 then this is the time to push for the PSMA PET CT to pinpoint where the blighters have been lurking. The location and number will then determine what the next treatment will be i.e. focal or systemic. When to act has been open to a lot of debate - do you hit it hard and fast with something like Triplet Therapy or focal+ HT in order to achieve a potential cure or do you treat it sequentially with palliative treatments when symptoms occur. 

I'm pretty much in a similar position ct and bone scan negative..Psa went down to 11.....after I went back on bicalutomide, from 33 .....3 months later its gone back up to29 ....so it's psma scan for me. 

That's what I'm waiting to find out....anybody read my last post....letter from my oncologist?I can't see it  online. 

Hello Big Col 

I have just checked and can't see a post from you with a letter from your oncologist - however if you posted a copy of it with any personal details showing - name, address etc - it would have been removed (I haven't removed it as I have been away from the forum for almost 4 weeks!).

Best wishes - Brian.

Is this it?

 Oncology letter 

 Oncology letter1 

Ah, that's me - when Big Col said "my last post" I only checked the last few, not going back 6 months - I've had a long hard day! (is that another glass of whisky I owe you??).

It looks like the next course of action for Big Col is a PSMA-PET scan as he's had Radiotherapy, so we need to know where the little blighters have gone to increase the PSA.

Best wishes - Brian

No I requested help on the terminology he uses Request psma scan if oligo metastatic progression evidence, consider metastases directed therapy.if poly metastatic seen to consider LHRH Analogues excting cardiovascular and cerebrovascular risk.The bone scan shows the aortic caval node is stable. That's all they can find the psma scan is to find out if there are any other sources  

The bottle is getting quite full now.

Which bit are you wanting help with. Oligo metastatic usually refers to up to 3 sites whereas Poly metastatic refers to more. It also depends on the positioning i.e. it is better for lymph node mets if they are in the same area or chain rather than spread over diffuse areas. If bone mets then each spot can be targeted. What it is saying is that they will hit a small number of mets individually, probably with radiotherapy. If several sites -Poly- then they will offer an injection/ implant hormone therapy and I would think they will monitor you closely for cardio and cerebrovascular risk.

I thought the aortic caval nodes were related to the lymphatic system so a little confused about the reference to the bone scan.