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My initial diagnosis route.61yrs old

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User
Posted 22 Sep 2024 at 10:35

Hi everyone

I'm currently waiting for my targeted GA transperineal biopsy results.

I just need to ask if any one on this forum has been tested for prostate metastases using a PSMA PET CT SCAN ? whilst having the initial staging done.

So far I've had a PSA test - 26ng

An abnormal DRE by my GP

mpMRI which shows T3aN0 

PIRADS 5 - Extracapsular extention.

PV32 PSAD 0.8 Normal seminal vesicles

Also had SPECT full body scan which shows "no convincing evidence of bony metastases"

Is this bone scan sufficient for ruling out micrometastatic prostate cancer or should I request a PSMA PET CT? which appears to be more accurate for ruling in/out prostate metastases. 

This would surely be best practice for initial staging where spreading of cancer cells would affect any treatment options being put forward by experts such as MDT panel.

I look forward to any of your thoughts on this. I live in North East of England and the hospital Trust has a new diagnostic centre that has the ability to carry out this scan too, but was not given the option because the urology department registrar told me this is not yet used for staging and referred me along with his urology consultant the not so accurate/sensitivity SPECT scan.

One week post biopsy and starting to feel much better after 4/5 days feeling sore and nauseous after 14 targeted biopsy cores taken. Hopefully 1 more week for pathology results.

Cheers

Dave

User
Posted 22 Sep 2024 at 13:46

Hello Dave,

I'm sorry that you've had to join us, but welcome to the forum.

My MRI scan in August 2022, showed T3a, my PSA was only 5.6

A GA transperineal biopsy in Sept 2022, showed Gleason 8 (4+4) in 20 out of 24 cores.

I had a CT scan with contrast and a whole body bone scan in Oct 2022. Neither showed any signs of metastatic disease.

In Feb 2024, I had robotic surgery. It was confirmed that I had EPE, T3a, Gleason upped to 9 (4+5).

So in answer to your question it appears I didn't have a PSMA. I'm ashamed to admit that the different types of scan have always confused me.

Best of luck with your biopsy results mate.

Edited by member 22 Sep 2024 at 14:22  | Reason: Typo

User
Posted 22 Sep 2024 at 16:40

Originally Posted by: Online Community Member

This would surely be best practice for initial staging where spreading of cancer cells would affect any treatment options being put forward by experts such as MDT panel.

I don't think you have said what treatment pathway you would find the most or least acceptable. It obviously depends on outlook,  but too much information can rule out some treatments or mean not having unnecessary treatments. About 7 years ago prior to my salvage RT, the urologist and oncologist said if we scan and find anything outside the prostate bed, SRT will not be an option, things have changed since then.

I am pretty sure there are guys on here who have had PSMA scans during the diagnosis period.

Hope all goes well for you.

Thanks Chris 

User
Posted 22 Sep 2024 at 17:44

Hi Dave,

My PSA was 36, T3BN0M0 at diagnosis and had a bone scan but was never offered a PMSA Pet Scan. Of all the guys I know through Maggies none of them were offered this type of scan at diagnosis. I live in Fife,Scotland and I don’t think it’s standard practice. I would say though that when I was diagnosed I knew nothing about a Pet Scan and I was just relieved that my bone scan was clear. I’m not sure what the answer would have been if I had asked, but they are very expensive to perform I believe…which is maybe why they’re not offered?

What I would say is if you’re unsure about this, consult your CNS and see what they say.

Good luck on your journey.

Derek

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User
Posted 22 Sep 2024 at 13:46

Hello Dave,

I'm sorry that you've had to join us, but welcome to the forum.

My MRI scan in August 2022, showed T3a, my PSA was only 5.6

A GA transperineal biopsy in Sept 2022, showed Gleason 8 (4+4) in 20 out of 24 cores.

I had a CT scan with contrast and a whole body bone scan in Oct 2022. Neither showed any signs of metastatic disease.

In Feb 2024, I had robotic surgery. It was confirmed that I had EPE, T3a, Gleason upped to 9 (4+5).

So in answer to your question it appears I didn't have a PSMA. I'm ashamed to admit that the different types of scan have always confused me.

Best of luck with your biopsy results mate.

Edited by member 22 Sep 2024 at 14:22  | Reason: Typo

User
Posted 22 Sep 2024 at 16:40

Originally Posted by: Online Community Member

This would surely be best practice for initial staging where spreading of cancer cells would affect any treatment options being put forward by experts such as MDT panel.

I don't think you have said what treatment pathway you would find the most or least acceptable. It obviously depends on outlook,  but too much information can rule out some treatments or mean not having unnecessary treatments. About 7 years ago prior to my salvage RT, the urologist and oncologist said if we scan and find anything outside the prostate bed, SRT will not be an option, things have changed since then.

I am pretty sure there are guys on here who have had PSMA scans during the diagnosis period.

Hope all goes well for you.

Thanks Chris 

User
Posted 22 Sep 2024 at 17:44

Hi Dave,

My PSA was 36, T3BN0M0 at diagnosis and had a bone scan but was never offered a PMSA Pet Scan. Of all the guys I know through Maggies none of them were offered this type of scan at diagnosis. I live in Fife,Scotland and I don’t think it’s standard practice. I would say though that when I was diagnosed I knew nothing about a Pet Scan and I was just relieved that my bone scan was clear. I’m not sure what the answer would have been if I had asked, but they are very expensive to perform I believe…which is maybe why they’re not offered?

What I would say is if you’re unsure about this, consult your CNS and see what they say.

Good luck on your journey.

Derek

 
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