Shoot i am back after 5 years

Steve1961

Some of you old timers will know who I am.anyway, five years ago at age 57 I was diagnosed with prostate cancer. My PSA level went up to 7.8. After a long, draining decision and chose to do radiation therapy with the booster. I still think I made a wrong decision but I have to live with it. PSA dropped down to 0.8. But over the last.nine months has risen to 1.78 going to make an appointment for PET scan to see if there is any reoccurrence. Wish me luck getting nervous I will report back.

Old Salt

I hope that's just a bump; not uncommon for patients who have had radiation therapy.

Steve1961

A bump after 5 years and 3 consecutive rises 3 minths apart ..i dont know .. question is do i had tge radiologist who did the therapy look at my past test results I’m wondering if an MRI of the prostrate wouod bd called for now or can you not do a biopsy of the prostrate after radiation what about an mri ofvthe prostate a pet scan I thought was of your whole body to see if it has spread I mean can it actually spread if it is still low 1.7 I guess I have some questions that need to be answered.

Steve1961

I guess what i asking is should i be seeing a urologist/prostate specialist instead of a radiologist

Clevelandguy

Hi,

If it was me I would be seeing both, but a Radiologist/Oncologist would be my primary go to doctor. PET scan is a great diagnostic tool. Make sure you get one of the more sensitive tracers for your PET scan to find the small metastasis if you have any. Since you probably still have live Prostate tissue left the reading could be from that. Good luck and pray for the best.

Dave 3+4

Steve1961

Thanks i am going to one of the best around ..iam sure i am in good hands

Old Salt

My background is similar. About a decade ago my prostate was heavily irradiated (SBRT + IMRT) after the initial diagnosis (Gleason 9). Several years later I had a concerning uptick in my PSA as well. I went back to the radiologist who had treated me. He prescribed an MRI with a 3T instrument. The image was read by a doctor with a lot of experience in interpreting prostate MRIs. The MRI technician told me that experience is really important reading these images. No cancerous lesions were seen according to the MRI report (what a relief!). MY PSA went down again a little later and has stayed at that level for several years. However, this could change...

More recently, the same (very experienced academic) radiologist (I see him once a year) told me that he now asks for a PSMA scan when there's a worrisome PSA reading. The latter scan is more sensitive. It appears that you will be getting that type of scan. I hope it will turn up nothing significant.

Steve1961

Thanks wow it seems ypur care team are experts for sure .i mean how so you know if your dr is an expert ..i assume mine is ..UCSF san francisco ..one of the top cancer centers ok ..my dr been with them 13 years now .ok i assume he is great .should i ask for a psma scan …. after reading what you said, a PET scan whixh i am supposed to get can detect cancer before it starts and spreads anywhere in your body so if the cancer is reoccurring and in the prostate, will it show up on the pet scan

Steve1961

Once again, I thank you for your advice I will not drive myself nuts again likei did before and to you wonderful people as well lol I listen to you people because you have experience and I looked up PSMA scan and yes it’s a breakthrough scan and they do it at the hospital. I’m going to, so I will make sure and that’s what I’m getting. Thanks again.

Steve1961

Oh, this is all I need to know once I have it done and get the results I will post again until then I will just keep my fingers crossed and pray for good results and for everybody on this forum like I always do and always have done

eonore

Hey Steve,

I am sorry you are back, but you have a lot going for you in facing this potential new challenge. The fact that you have been following you PSA closely means that you can get on top of this right away, and the fact that you are at a top notch facility puts you ahead of the game. I have a friend who recurred after initial radiation, and he was treated successfully with cryotherapy. Keep your chin up and hopefully you’ll be able to put this behind you.

Eric

OrbinM

I am now scheduled for a pet scan for better evaluation of the prostate cancer.

I have an inflammatory disease that has showed up in the bone in 2021, so now am doing a prostate specific scan. still leaning toward cyberknife.

Steve1961

Has anyone Add a PSMA scan if so, what is it like? Is it toube larger than an MRI rube ? How long are you in there? They say about 20 minutes. The pictures I am seeing a tube look a lot bigger. I hope so. It’s strange over the years seems it’s getting harder for me to stay with machines I literally borderline start to freak out not good. I may have to ask for a Sedative

On_A_Journey

G'day @Steve1961,

I have had three PSMA PET Scans, which have all come back negative. They are probably false negatives. I got my first one when I hit the biochemical recurrence trigger of 0.20 (I had surgery as my primary treatment), my second a year later when my PSA was 0.38 and my last 10 months later when my PSA was 0.57. Although my PSA is still relatively low, it was rising quickly in percentage terms over the past few years and a bit of panic set in.

There is some good advice around that says that the scans are more than likely able to detect cancerous cells once your PSA is over 1.0, so you should probably only need to have one scan to see what is going on.

On the day, the whole process takes a good couple of hours, but the scan itself is only about half an hour. It's no big deal. You will be asked to front up well hydrated but not bursting; for me, for a late morning scan, I have a normal breakfast with a glass of juice and a cup of tea, then a couple of glasses of water. You will be led into a small isolation room and fitted with a cannula to your arm. A tube will be passed through a glory hole(!) and the nurse will hook it up. You are then left on your own for about 90 minutes, during which time you are still encouraged to drink some water. The stuff that is being injected into your arm is radioactive, hence the isolation. So sit back in the recliner, watch TV or play games on your phone, or have a nap. You are allowed to buzz for the nurse to disconnect you if you need the toilet during this time. The stuff that went into your arm only took a few minutes but you are left hooked up until you need to be disconnected. After about 90 minutes you will be taken to the room that houses the machine. You will lay on your back and your body will be passed slowly all the way through the donut, then every few minutes it will increment a few inches the other way. It is not hard to stay perfectly still during the scan, in fact, I normally doze off.

Hope this helps.

Steve1961

Wow wow wow a tube in the glory hole WTH i didnt read anything about that ..r u talking about a catheter why would you need one of those . Also ths machine is it bigger than an mri how close is tube to your nose that is my concern I’m getting a bit claustrophobic in my old age

On_A_Journey

No no no! Lol, sorry!

The tube that puts the radioactive stuff in your arm is passed through a hole in the wall and hooked up to you. It is then injected remotely, from the next room presumably. I'm assuming it is done the same way everywhere. I only said the phrase glory hole for humour!

Not sure if the machine is bigger than an MRI machine; I suspect not, but there seemed to be PLENTY of room in there. A good foot of clearance above your nose. Google 'pet scan machine' and look at images.

Steve1961

Ha ha ha thanks i feel condident now its going to be all good

A88M

No sedation required.

Steve1961

It’s all done Fortunately I get to go to a facility. Called UCSF San Francisco. All relatively new Validated underground parking nurse let me into a little section with a big reclining chair in the TV and put an IV in my arm and said she’ll be back in about 10 minutes and then when she came back in 10 minutes she injected a big bottle of I guess that radioactive stuff into my arm and then she said I’ll be back in 45 minutes and I watch TV and then like you said on the table and 20 minutes Later, I was done even got to wear my own Clothes I have a zoom appointment thursday to go over the results. I’ll hope for the best. Thanks

Steve1961

Got my scan reauots back i looked at it myself unfortunately looks like I have a reoccurrence. Dammit I’ll know for sure Thursday but I have a feeling I’m gonna have to need some kind of treatment again. This is what it said. Intense focal radiotracer uptake in prostate bed .. I looked it up and well it’s not good

eonore

Hey Steve,

If that is the only finding (prostate bed), that very well may be good news. If you have a recurrence, the tumor being confined to the prostate bed is the best place for treatment, rather than disease that has spread further afield. Keep your chin up and wait for Thursday.

Eric