Do I need an Axumin PET Scan?

skelly31

I was diagnosed with gleason 6 prostate cancer 5 years ago. Biopsy 2 was negative, biopsy 3 was prostate (gleason 6 <5% of one core). Ready to get my 5 year biopsy. Had 2 MRI's and they were negative. Should I get Axumin PET now? (My PSA has gone up from 4.5 to about 7.4 in the last 5 years.)

Clevelandguy

Hi,

If it was me I would wait for the results of your next biopsy then with your doctors decide if you need a PET scan. Your increase in PSA could come from BPH, an inflamed Prostate, or more aggressive cancer. Is it normal for a person with diagnosed cancer to get a biopsy every five years, I thought they would come more frequent than that? When did you have your latest MRI?

Dave 3+4

Georges Calvez

I would wait for the results of the biopsy and see where you go from there. There is no absolute correlation between PSA levels and the progress of the cancer, in fact it can vary by substantial amounts for no apparent reason. Given the very low levels of cancer found in your last biopsy, the next one could find more, less or none depending on where the needles are targeted.

skelly31

https://csn.cancer.org/discussion/comment/1694491#Comment_1694491

Definitely have the BPH (143) and rising. Measured 88 (Oct '17) Measured 99 (Aug '19) Measured 143 (Nov '21)

Biopsy 1 (oct '17) Biopsy 2 (Feb '18) Biopsy 3 (Aug '19) Biopsy 4 this coming November.

MRI 1 Jan 18 MRI Spine May 18 MRI Prostate Nov '21... all were "negative/normal".

Thanks for your input.

ASAdvocate

You have a PSA Density of only .051. That is way below the .1 that Johns Hopkins uses as their “caution zone” for suspicion of higher cancer in their AS patients.

So, you certainly have a BPH problem, but your prostate cancer sounds typical of men with very small amounts of Gleason 6.

You may want to research aquablation as a BPH treatment. I heard a provider say that they will treat men with low risk prostate cancer. Aquablation seems to be the latest advancement in treating BPH, with good success and few side effects.

Clevelandguy

https://csn.cancer.org/discussion/comment/1694493#Comment_1694493

Hi,

Hopefully it is BPH causing your rise in PSA. Glad to hear your are checking with yearly biopsies.

Dave 3+4

Old Salt

I agree with the others that an Axumin scan is not appropriate at this time. I don't know where you are, but I doubt that US insurance would cover (most of) the cost and/or that your doctor would go along.

More in general, I do hope that BPH is the proper explanation for the rise in your PSA.

centralPA

https://csn.cancer.org/discussion/comment/1694493#Comment_1694493

Is that CCs? 143 is a large prostate, and that is a rapid growth rate. It’d be worth calculating what your PSA Density is, taking the PSA value and dividing it by the prostate size. I’m betting it has held even or gone down.

I am in a similar situation, on AS with 3+4=7, 140cc prostate. I am looking at a HoLEP procedure to solve the BPH problem, but a HoLEP also basically hollows out your prostate, greatly reducing its mass, and they can do a pathology exam on the contents. I meet with the surgeon in a couple of weeks to discuss.

Best of luck!

ASAdvocate

https://csn.cancer.org/discussion/comment/1694586#Comment_1694586

I calculated the PSA density in an above post.