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PET Scan

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User

Posted 27 Oct 2017 at 08:30

Hello everybody

Has anyone heard of or had a Choline PET Scan ?

What does it entail ?

Also, is there anyone who is on the National trial where further sessions of Radiotherapy are given to specific sites ?

I am asking all of these questions as this is a strong possibility for me in early 2018......I am coming off the Hormone treatment ( injections) after November in order for my PSA to rise and depending on speed of rise I will qualify to have the scan and possible subsequent radiotherapy.....

However, if my PSA rises quickly ( which it did last time I came off treatment) to 9 or 10 I will be going back on Hormone Treatment.

Any thoughts, information, experiences etc. would be appreciated, thanks.

Regards to all.

Dave

User

Posted 27 Oct 2017 at 14:08

Hi Dave,

First something I noticed in your Bio. You say you were to have 39 fractions of RT but were only given 37. You had the standard amount for the UK according to NICE guidelines and I have not heard of anybody having more fractions as a course for a number of years. There is a move to reduce this to 19 or 20 fractions of higher dose though.

As regards your possible Choline PET scan you don't notice any significant difference between this and having the usual contrast that is added. However, Choline has a very short life and mostly where the scan is done it is prepared offsite specifically for the recipient and rushed to the hospital. Few if any UK hospitals have the necessary synchrotron or cyclotron to produce it yet. Unfortunately, it often fails a quality control check and another batch has to be made up. I and other members at UCLH in London have experienced such a failure so be prepared for this. (I was lucky that the second batch made for me was OK but one member here who traveled quite a way for the scan and the choline was not of acceptable standard then stayed in London overnight for the scan next day).

I spoke with the radiographer about the scan and he said that MRI with Choline was better for Prostate so this is what he would give me. The uptake of choline helps show where the cancer is although not definitively, as results are subject to interpretation as mine were when sent to other hospitals. who had a different opinion.

Please let us know how you get on and what further treatment you have.

Edited by member 27 Oct 2017 at 14:44 | Reason: Not specified

Barry

User

Posted 27 Oct 2017 at 15:43

Hi Dave,
I had a PET scan , I was in the clinic for 2 hours, first off you have the injection and then wait for it to get into your system , after which you have the scan, I must say although I was under the NHS this was a private clinic and I was really looked after. That said I had further MRI scan to see whether the cancer had moved into my bones , luckily it had not.
Best of Luck
James

User

Posted 27 Oct 2017 at 16:11

Hi
Please click my picture and read my profile. I had prostate removal surgery at 48 but very rapid rising psa unfortunately. They gave me a Choline PET at psa 2.2 but ideally your psa needs to be over 3. They found nothing in the scan. I had 3 visits to Oxford before they got it right as Barry says. I then went on HT for a year but came off to let the psa rise again so I could have a PSMA PET scan at London. I had two cancellations there also. The scan again found nothing. I’m not sure of the reliability of the injections:markers tbh.
I’m presently off any treatment at all and just letting it grow but living a normal life as best I can. Reserving further HT and Chemo for when anything is found.

User

Posted 27 Oct 2017 at 17:06

I had a Choline PET scan at Birmingham and the process was smooth and efficient, just like a CAT scan with contrast. The pictures obtained showed high take up areas in colour as opposed to the conventional monochrome ones. Supposedly the PET scan has higher resolution than most CAT scans, so can be more accurate as well as finding smaller Mets.

User

Posted 27 Oct 2017 at 17:10

Hi Dave, I had a choline PET scan last December. As has been said by James you are taken to a room where a cannula is inserted. They then bring in the radioactive injection in a lead shield and inject the choline F18 in my case into you.
You then wait in the room for a while to let the injection over to the right places.
You are told to be careful with your urine output for a short time, any spillage will be radioactive.
I had two scans one after the other. First one of the whole body, second one a more detailed look at the pelvic area.
I found lying in the scanner with my arms up past my head for forty minutes very uncomfortable.

As Barry has said the production of choline is difficult and has a low yield.
My first scan was cancelled because the yield had been so poor it would have been useless.
They made new material the next morning and I had my scan that afternoon.
Best wishes, Ian.

Ido4

User

Posted 27 Oct 2017 at 21:56

Thanks to all who have replied up to now.
I’ve been on Hormone treatment 3 times since finishing my Radical Radiotherapy in December 2009....whenever I come off it my PSA rises quickly.... it went from 0.9 at the end of August 2016 to 8.7 by 1st December 2016, hence my belief that it will do similar this time.....which means I’ll not be going for the PET Scan and going back on HT.
My Oncologist says he expects it to rise quickly again this time, so all very worrying.
Anyway, nothing I can do but wait, see what happens with my PSA in February next year.

Good luck to everyone......I’ve not posted or updated my bio etc for some time, it has been quite a while since diagnosis in 2009, lots of ups & downs physically & mentally.

User

Posted 06 Sep 2018 at 07:13

Hello everyone.
I eventually had the PET Scan at the end of July.
My PET Scan result indicated metastasis in right side of my Ischium.....being referred to Nottingham for possibility high dose RT, 3 to 5 sessions which my Oncologist says will postpone going back on HT.

Is or has anyone had the same circumstances ?

PSA risen from 2.7 at the end of May to 12.8 at the end of July.

Not sure about all of this but should find out more after my first appointment on Monday when I see the Bone Cancer Specialist, have a CT Scan and have the RT planning session.

Has anyone been in the same circumstances ?.....any advice or information would be appreciated.

Regards to all

Dayo

User

Posted 06 Sep 2018 at 11:36

Hi Dave,

If all that could be found on your scan was mets as you reported, hopefully the specifically targeted RT will deal with this. There is no guarantee that some cancer cells will not spread elsewhere. (There may already some micro cells that are too small to be seen on a scan in the process of doing this but hopefully not). There comes a limit to the number of times any subsequent spread can be dealt with in this way. It becomes a matter of personal judgement as to whether you continue with HT in the hope that it may stop or slow any subsequent spread or have a break from HT and monitor the situation and only revert to HT if PSA rises significantly. Then you could discuss resumption and suitability of Intermittent HT (HT holidays). Clearly, nobody who has experienced the side effects of HT wants to go back on it unless considered useful.

I have resisted resuming HT again because a PSMA scan showed my cancer still in my Prostate and I hope another treatment will eradicate it. However, if there is subsequently found to be spread at some stage, I would then be in a similar situation to you looking at RT to a single or few mets (oligometastases) and likely need for HT.

Barry

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