Hello all,
It's been a while since posting here.
To be honest I'm a bit frustrated with gp. Back in October 2018 Pete's PSA had risen to 0.1. 2 years later in Oct 2020 it rose to 0.2.
March 2021 rose to 0.3 still 0.3 today.
The only reason Pete is seeing a consultant finally on Monday is because I pushed to get an appt. This is a man whose original diagnosis was t3 n1 m0. And Gleason 9!
I'm rather worried that scan might reveal a spread to bone, although Pete has no pain or any symptoms to suggest that. I appreciate we've had covid etc, but the more I think of how casual the GPS were, the more astounded I am. He's not been under a consultant for 4 years now!
Should I push for a pet scan etc?
Many thanks
'Sorrow looks back, worry looks around, but faith looks up' |
User
Given that Peter's already had salvage RT, treatment from this point on really is a case of "management". The fact that his PSA appears to be stable is excellent news - there's no "doubling time". To be honest, I strongly suspect that they'll do nothing until there is a continuous and sustained rise in PSA. Every treatment is only effective for a limited period of time, so it's a case of using each one at the time when it'll be most beneficial.
Best wishes,
Chris
User
I agree with Chris it is a case of management, and I agree with you that management is better done by a consultant than a GP.
I don't know enough about PSMA scans and treatment options to give any strong opinion. It does seem now that if there are just a few mets then SABR can be used. I think once you have one met in reality you have a strong chance of micro-mets anywhere and SABR is unlikely to irradicate cancer from your body.
I guess on balance I probably would ask for a scan to see if there is anything which can be treated.
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User
P and A.
Certainly push for the scan, but as you probably already know 0.3 is quite low for detecting the source.
I was in a similar position but with lower Gleason. My onco nurse said a scan possibly at a PSA of 1, my oncologist said 2, 4 or even 8 before we would scan, he said PSA velocity was more of a consideration.
Often said, the sooner HT starts the sooner it becomes less effective.
Thanks Chris
User
Press for a Gallium 68 PET-PSMA scan, although nothing might show up, (£2600 privately), but if you get on an NHS waiting list, he might get one in a year or so when things might be clearer.
Consider a second opinion from another oncologist, either NHS or private.
Best of luck.
Cheers, John.