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User
Posted 19 Jul 2022 at 21:41
Bri, there are different things all referred to as F18 or 18F.

F18 sodium fluoride is a bone scan

18F PSMA is a highly sensitive tracer which can pick up small cancer clusters anywhere in the body if the cancer cells are PSMA reactive. It has some disadvantages compared to Ga68 but also performs better in some situations. There is a small number of men whose cancer is PSMA negative and for these, Ga68 and 18F will not pick up the cancer sites.

F18 fluciclovine (previously known as FACBC but also called axumin) is usually better than choline at low PSA readings, not quite as reliable as a PSMA scan using 18F or Ga68 but more stable, easier to produce and transport. 18F FACBC / axumin is not a PSMA scan so may be successful for those men who are not PSMA+

This is an interesting paper published last year

https://www.frontiersin.org/articles/10.3389/fonc.2021.684629/full

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 Jul 2022 at 22:41

Originally Posted by: Online Community Member
Bri, there are different things all referred to as F18 or 18F.

F18 sodium fluoride is a bone scan

18F PSMA is a highly sensitive tracer which can pick up small cancer clusters anywhere in the body if the cancer cells are PSMA reactive. It has some disadvantages compared to Ga68 but also performs better in some situations. There is a small number of men whose cancer is PSMA negative and for these, Ga68 and 18F will not pick up the cancer sites.

F18 fluciclovine (previously known as FACBC but also called axumin) is usually better than choline at low PSA readings, not quite as reliable as a PSMA scan using 18F or Ga68 but more stable, easier to produce and transport. 18F FACBC / axumin is not a PSMA scan so may be successful for those men who are not PSMA+

This is an interesting paper published last year
https://www.frontiersin.org/articles/10.3389/fonc.2021.684629/full

Great post Lyn, helps us to understand the scans a bit more.

Not sure if I’ve asked this question before but is there a chance that some cancer cells are PSMA reactive and some aren’t?

Thank you

User
Posted 19 Jul 2022 at 23:22

Lyn,

This is the exact copy from my appointment letter , "NM F18 half body PSMA PET/CT scan" I am fairly confident I had the F18 fluciclovine tracer, my PSA was 1.6.Presumably it was not a PSMA scan.

The scan did light up a single lymph node. 

"18F PSMA is a highly sensitive tracer which can pick up small cancer clusters anywhere in the body if the cancer cells are PSMA reactive. It has some disadvantages compared to Ga68 but also performs better in some situations. There is a small number of men whose cancer is PSMA negative and for these, Ga68 and 18F will not pick up the cancer sites.

F18 fluciclovine (previously known as FACBC but also called axumin) is usually better than choline at low PSA readings, not quite as reliable as a PSMA scan using 18F or Ga68 but more stable, easier to produce and transport. 18F FACBC / axumin is not a PSMA scan so may be successful for those men who are not PSMA+"

Is there a chance that any smaller clusters of cancer cells have been missed by the F18 fluciclovine, that could have been picked up by the 18f or Ga68. I realise the scans are not infallible, as we saw with CJ. I have already had my fair share of adverse effects and apparently now risk bowel damage from the SARB. 

I don't want to go head on into another treatment then finding out I could have had a better investigation.

Thanks Chris 

 

Edited by member 19 Jul 2022 at 23:23  | Reason: Spelling

User
Posted 20 Jul 2022 at 00:13
"Lyn,

This is the exact copy from my appointment letter , "NM F18 half body PSMA PET/CT scan" I am fairly confident I had the F18 fluciclovine tracer, my PSA was 1.6.Presumably it was not a PSMA scan."

You should ask your onco in case I have got it wrong about Axumin but my guess is that you had F18 PSMA 1007 not fluciclovine. I don't think they would have written on the letter that you had a PSMA scan if you didn't.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 Jul 2022 at 00:19
"Not sure if I’ve asked this question before but is there a chance that some cancer cells are PSMA reactive and some aren’t?"

Others here know more than me about this but I think that you are either PSMA+ or you aren't. Some clusters may be too small to show clearly which then leads to equivocal scan results and doctors comparing the images from MRI, bone scan and PET scan to form a view?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 Jul 2022 at 10:17

Originally Posted by: Online Community Member
"Lyn,

This is the exact copy from my appointment letter , "NM F18 half body PSMA PET/CT scan" I am fairly confident I had the F18 fluciclovine tracer, my PSA was 1.6.Presumably it was not a PSMA scan."

You should ask your onco in case I have got it wrong about Axumin but my guess is that you had F18 PSMA 1007 not fluciclovine. I don't think they would have written on the letter that you had a PSMA scan if you didn't.

 

Lyn, thanks for the reply, I have just had it confirmed that the tracer was the 1007 as you said. Is there a better scan that may pick up things the 1007 may have missed ? 

I know these are things to discuss with the Onco but I have been told there is a risk of bowel damage from the SARB , why risk that if there are other things lurking elsewhere. I really don't want HT and I have given it my best shot so far, there is a time to go for quality over quantity.

Thanks Chris 

 

 

 

User
Posted 20 Jul 2022 at 11:55
"I have just had it confirmed that the tracer was the 1007 as you said. Is there a better scan that may pick up things the 1007 may have missed ?"

No, comparison trials suggest that Ga68 and F18-1007 are just about the best you can get and fairly equal. 1007 may be slightly better at picking up activity in lymph nodes.

I am surprised that they are saying there is a risk of bowel damage - SABR is so precise. Maybe they are just doing the usual worst case scenario thing?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 Jul 2022 at 13:06

Lyn , thank you for your reply, that is quite reassuring. Just watching some Dr Kwon videos who talks about SARB, surgery or cryotherapy for treatment to a single lymph node. 

I will go through the bowel damage scenario with the Onco.

CT and planning scan appointment arrived today for tomorrow.

Thanks Chris.

 

Edited by member 20 Jul 2022 at 16:39  | Reason: Not specified

User
Posted 21 Jul 2022 at 21:42

Hi , I had my meeting with the oncologist (J) today. Perhaps because of my history of adverse effects ,  he did paint quite a grim picture of possible adverse effects, he did qualify it with, they only affect around 1percent of SARB patients. He also said further scans would not reveal anything else. 

So the planning CT scan went ahead 2 of the three almost faded tattoos were redone along with a fresh one at the front. 

Treatment in 3 to 4 weeks time, a  maximum of five sessions on alternate days.

He did say the area of interest was around 8mm, I don't think he likes my engineering type questions.

Now I have got my dispute with the dentist resolved I am hoping to get that treatment out of the way before the SARB treatment.

Still interested to hear from any guys who have had SARB treatment in a similar situation.

Thanks Chris 

Edited by member 21 Jul 2022 at 22:59  | Reason: Not specified

User
Posted 22 Jul 2022 at 09:23

Hope it all goes well Chris. 

Ido4

User
Posted 27 Jul 2022 at 11:46
Good luck
User
Posted 30 Jul 2022 at 09:52

Scholars, my recent scan only proved one site of cancer in a pelvic lymph. How do I describe my cancer ,i.e , metastatic , advanced or something else. Provisional date for  SABR treatment 8/8/22. 

Thanks Chris 

User
Posted 30 Jul 2022 at 10:50
It is advanced with spread to lymph nodes only at the moment Chris , so technically curable although the lymph system is a super-highway. That is I only had 2 lymphs in abdomen but now one up in shoulder and one near my lungs. Hopefully after zapping your psa will stay down a good while. Insurance wise you are good to go. They normally happy with spread to local lymphs only. It’s when the bones get involved …….

Good luck friend

User
Posted 30 Jul 2022 at 13:27

Sorry you’re having to deal with this Chris. Here’s hoping the SABR sorts it. 

Ido4

User
Posted 11 Aug 2022 at 10:55

I had session 2 of 5 yesterday, I am having 30gy over 5 sessions. The treatment room is lovely and cool , pity the treatment doesn't last longer. Perhaps coincidence but my skin felt like it was burning for a couple of hours about two hours after treatment, nothing to see on the skin and all back to normal now.  As usual the RT staff are absolutely brilliant.

Thanks Chris 

 

8/8/2022 to 17/8/2022, 30gys over 5 sessions of SABR treatment to a pelvic lymph node. 

 

 

 

.

Edited by member 18 Aug 2022 at 23:04  | Reason: Not specified

User
Posted 11 Aug 2022 at 19:52

A nice cool room in the middle of a raging heatwave. As they say, every cloud has a silver lining. I hope the SABR does the trick. Chris

User
Posted 11 Aug 2022 at 20:02
Hope it all goes ok Chris. I ended up with 3 squares of red skin when I had my spine and ribs done , but it wasn’t sore and went away in the end. It did cause some internal issues with Oesophagus and lungs etc but yours is down below so to speak. I got piles 2 weeks after for the first time in my life but that sorted too. They gave me a bottle of Morphine in case I got tumour flare but that never happened either. It has been opened for the odd dabble though 😊

Good luck

User
Posted 30 Sep 2022 at 16:55

Hi. My PSA had been rising by roughly 0.1 per month for the last few months.

My last PSA on the 5/8/22 was 1.8.

SABR treatment to a single lymph node was 5 sessions between 8/8/22 and 17/8/22.

PSA yesterday 30/9/22 was again 1.8.

Perhaps yesterdays blood test was a bit too soon and based on previous trends there would normally have been a rise, but I was expecting a fall.

Has anyone else is got experience of PSA trends after SABR. Are PSA trends after SABR the same as after RT and SRT.

I see the oncologist on Tuesday. 

Thanks Chris 

User
Posted 02 Oct 2022 at 06:41
Thought the matron always said it can actually go up because of cell death releasing PSA?
User
Posted 02 Oct 2022 at 12:01
It may just be a bit too soon; PSA isn't really a reliable indicator of the effectiveness of RT in the early days after treatment so it's possible that the same applies to SABR. Alternatively, it may be that the node that was zapped is not where the PSA is being generated
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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