Question About Scans and Low PSA
My question is are results from the use of C11 Pet scans with low PSA values determined simply by a matter of probability with high GL being the greater probability? I noticed Dr Eugene Kwon reporting C11 Choline Pet scan results on patients having a PSA of 0.
How do you determine when to use these types of scans - particularly after having already gone through treatment (surgery or radiation) and with a low PSA? Is it incorrect to assume that these types of scans should only be used when the PSA rises to predetermined value?
VascodaGama Member Posts: 3,598 MemberHighest probability in detecting the bandit
In my opinion, our main purpose in undertaking the C11 PET/CT exam is to locate the cancer. We know that we got it because of an increasing PSA or symptoms, and want to tackle it the best way possible with the intent of “killing” it for good (with surgery or radiation), or, in the impossibility of cure, at least have a better diagnosis of one’s status. If cancer is found in an organ or in a place restrictive to operation then one can avoid those treatments and chose a palliative way that best fits his preferences.
In other words, the exam should be done when the conditions are propitious for a positive result avoiding false negatives to the maximum extent, but not too late that would allow the bandit to spread freely. We should look for the highest probability in detecting the bandit.
Through experiences and trials we know that the traditional CT, MRI and Bone scintigraphy scans are not reliable in small size PCa lesions, however, the combination of PET/CT have shown better results when using particular contrast agents. From trials it was found that some contrasts have better outcomes (positive results) depending on the grade of the cancer (Gleason) the level of the PSA (size) and spread (location). C11 and F18 choline and the novel tracer PSMA seem to be the best choice but the 18F FDG (fluorodeoxyglucose) is practical in symptomatic osseous lesions. The best level in terms of PSA for all the tests is above 2.0 with the new tracer PSMA improving the possibility of detection in levels above 1.2.
Dr. Eugene Kwon may have his own particular threshold table he trusts to be good but such level of PSA=0.0 is not judged as a proper marker in trials worldwide.
I would recommend you to draw conclusions after reading the details in these links;
Best wishes for peace of mind.
hopeful and optimistic Member Posts: 2,333 Member
Pet scan c11Old Salt said:
Why don't you ask Dr Kwon what the rationale is for doing the scan(s)?
Is it possible you are in a clinincal trial?
Another place for advanced pet ct scan using c11 acetate is in Arizona, Dr. Fabio Almeida runs this one..
Also UCLA does this pet scan as well.
As Vasco mentioned in order to be a candidate, your PSA has to be high enough so that the tests can be effective.
As I understand you have to pay out of pocket0
- 120.1K All Discussion Boards
- 6 CSN Information
- 6 Welcome to CSN
- 120.3K Cancer specific
- 2.8K Anal Cancer
- 437 Bladder Cancer
- 302 Bone Cancers
- 1.6K Brain Cancer
- 28.3K Breast Cancer
- 384 Childhood Cancers
- 27.8K Colorectal Cancer
- 4.6K Esophageal Cancer
- 1.1K Gynecological Cancers (other than ovarian and uterine)
- 12.7K Head and Neck Cancer
- 6.3K Kidney Cancer
- 654 Leukemia
- 772 Liver Cancer
- 4.1K Lung Cancer
- 5K Lymphoma (Hodgkin and Non-Hodgkin)
- 228 Multiple Myeloma
- 7.1K Ovarian Cancer
- 39 Pancreatic Cancer
- 481 Peritoneal Cancer
- 5.1K Prostate Cancer
- 1.2K Rare and Other Cancers
- 528 Sarcoma
- 699 Skin Cancer
- 640 Stomach Cancer
- 190 Testicular Cancer
- 1.5K Thyroid Cancer
- 5.7K Uterine Cancer
- 6.2K Other Discussion Boards