PSMA PET scan

Hi Porthleven good question.  The general feeling is that if PCa is spreading it is first detected in the blood (PSA).  Sadly until the spread has sufficiently multiplied, even a PET PSMA can’t find them.  What is his PSA reading for the last 3 readings?

Hello Porthleven 

I've had one - but my cancer is a biochemical relapse and we still couldn't find where the cancer is lurking. I am a T3aNoMo with potential lymph node involvement (these have been zapped by radiotherapy).

If the Bone and CT scan are clear, it's highly unlikely you will get a PSMA-PET scan and the one word preventing this is COST (£2750 - £3000 per scan). 

The scan is quite often offered - Post surgery with a PSA of +0.2,  After Radiotherapy with a rise of +2, High risk Gleason 9/10 with a PSA of +20 when spread shown on MRI + Bone Scan and Biochemical recurrence.

There's no cost to you in asking!

Best wishes - Brian.

Hi Porthleven,

I agree with Millibob that you should ask for one. Please have a look at my profile on the PSMA section. I was T3a Gleason 4+5 and was lucky(?) enough to be referred for a PSMA scan. Nothing showed on CT and bone scans initially, like you. It showed up some pelvic lymph node involvement and set my treatment on altogether more positive paths as an N1 that would not have otherwise been open to me. In my view, this should be the patient-centred standard of care for people in our situation. The cost is the obstacle, but with persistence you may 'get lucky' as I did.

All the Best

David

My lovely husband was offered a PSMA pet scan after an MRI and an MRI marrow showed nothing outside the gland. I think they felt that with a PSA of 57 and a tumour that was on both sides of the prostate and close to the edge spread was likely. He was told that this was the policy of the hospital (Churchill, Oxford).  PSMA PET showed nothing outside the gland but they are going to zap the nodes with RT as well as the gland to be safe.

I would certainly ask about a PSMA PET. It does seem to vary from hospital to hospital. Do you know if your hospital has a machine onsite?

Good luck!

Thanks for replying. Psa first discovered in January of 25. Four weeks later 26.7. No further readings taken. He has spoken with the cancer nurse, Who said as the bone and CT scans showed no areas of concern a PSMA pet scan wouldn’t be done at this stage. He has just received an appointment with the clinical oncologist at the hospital where he’ll have radio therapy (different hospital to urology) so he might speak to her about it. 

Hi, he has asked but as previous  scans are clear they have said no.  He has an initial meeting with the Oncologist at the RT centre in a couple of weeks so might mention to her.

thanks for replying 

My husbands PSA is around 25/27 or at least is was in January when first diagnosed. His cancer is also in both sides of the prostate, although one side more than the other. Gleason 9 (4+5). He’s going to discuss with the oncologist when he meets with her in a few weeks time. I dont think either of the hospitals he is at (one for urology and a separate one for oncology/RT) have a scanner, would probably have to go to Southampton as I think the major cancer centre there has one.

Pet scan was final piece of diagnosis jigsaw for me ,it found bone metastasis that bone scan didnt ,then after a few months RT started 

Hi Porthleven,

if you can, do go to Southampton for RT !  I had my RT there, they have 6 LINACs on site, all fitted with SGRT. My Oncology/Urology teams were at Salisbury. I was originally referred to another hospital for my RT. They refused to treat me as I have two replacement hips - Southampton said that this was "no problem" to them.

I had a 90 mile round train/bus trip every day to get there, it was worth every yard ! You couldn't fault the staff or the up to date equipment they have there.

I had brilliant service from both the above mentioned hospitals.

Thanks for that. Initially We are seeing the team in Swindon at the relatively new radiotherapy centre there.  We are a little concerned that if the issues continue in the gulf,  petrol for 600 miles a week might be problematic, not in cost but possibly with availability. Trains are not ideal from our location, would be a 25 minute drive, over an hour on the train, then a bus to the hospital from Southampton station, so around two hours each way. Swindon is a 40 minute drive. My husband does have a replacement hip, just the one, if we don’t feel confident with oncology at Swindon or if they feel SGRT might be more beneficial with the hip issue, we may have to go to Southampton. Appointment is in two weeks time.