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Inconclusive scans

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User
Posted 30 Jun 2025 at 22:21

Husband’s PSA on the rise (surgery 5yrs ago followed by adjuvant RT). Was <0.1 for over four years, then jumped  to  0.2. MRI and CT were inconclusive. At 0.4 he had a PSMA PET scan in April which showed an indeterminate area on spine and they recommend repeating the scan in six months.

He sees Oncologist in a week to discuss formal report - is there anything we should be pushing for?

Thank you.

User
Posted 01 Jul 2025 at 01:57
Has hubby been having HT and if stopped when? Dr may want to wait for another PET scan to check more certainty re precise location and whether any other suspicious areas. Depending on findings some radiation may be a possibility together with some HT. But his Dr is best placed to suggest most appropriate way forward. Do let us know what he says following imminent appointment.
Barry
User
Posted 01 Jul 2025 at 12:40

Hi Lexi, sorry to hear about the increase in PSA and the inconclusive scan. I would push for more frequent PSA testing. My gallium PSMA scans seemed to accelerate the rise in my PSA . The research professor at our local support group had not heard of that happening. Take care.

Thanks Chris 

 

User
Posted 02 Jul 2025 at 01:31
Oncologists can have different ideas on pescribing HT in such circumstances but they know the individual patient best and we generally trust our Consultant's judgement. It will be interesting to learn what your Husband's Consultant has to say.
Barry
User
Posted 02 Jul 2025 at 05:53
Questions I would ask:

Was the adjuvant RT prostate bed only? Or were lymph nodes in wider pelvis area treated too?

Can't they MRI or biopsy the possible spinal lesion?

Can they just blast the spinal lesion and not wait?

User
Posted 02 Jul 2025 at 21:17
Lexi26, my case doesn't quite relate to your husband's, I had surgery without adjuvant RT but then after a rise in PSA had HT and salvage RT six years later. However what might be relevant was the advice of the oncologist when my PSA rose above 0.2 that he saw no point in me having a scan. He said that in his experience scans couldn't be relied on to provide information when PSA was less than 0.5 and that it would be best to start the salvage treatment at a lower PSA.

(Basically, with PSA at 0.3 or 0.4 he wouldn't take a negative scan as meaningful, there would be too much risk in not going ahead with salvage treatment, so there was no point in a scan which didn't guide the clinical approach).

User
Posted 05 Jul 2025 at 00:09
So he still has the option of wider pelvic nodes irradiation.

I would also ask about the benefit of early chemo.

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User
Posted 01 Jul 2025 at 01:57
Has hubby been having HT and if stopped when? Dr may want to wait for another PET scan to check more certainty re precise location and whether any other suspicious areas. Depending on findings some radiation may be a possibility together with some HT. But his Dr is best placed to suggest most appropriate way forward. Do let us know what he says following imminent appointment.
Barry
User
Posted 01 Jul 2025 at 12:40

Hi Lexi, sorry to hear about the increase in PSA and the inconclusive scan. I would push for more frequent PSA testing. My gallium PSMA scans seemed to accelerate the rise in my PSA . The research professor at our local support group had not heard of that happening. Take care.

Thanks Chris 

 

User
Posted 01 Jul 2025 at 17:49

Barry he has never been prescribed HT. His oncologist said in my husband’s case when going for adjuvant RT at 14 weeks post op that HT would have no added benefit.

We meet him again next week to discuss.

PSA has been 3 monthly since the rise Chris.

Thanks

User
Posted 02 Jul 2025 at 01:31
Oncologists can have different ideas on pescribing HT in such circumstances but they know the individual patient best and we generally trust our Consultant's judgement. It will be interesting to learn what your Husband's Consultant has to say.
Barry
User
Posted 02 Jul 2025 at 05:53
Questions I would ask:

Was the adjuvant RT prostate bed only? Or were lymph nodes in wider pelvis area treated too?

Can't they MRI or biopsy the possible spinal lesion?

Can they just blast the spinal lesion and not wait?

User
Posted 02 Jul 2025 at 21:17
Lexi26, my case doesn't quite relate to your husband's, I had surgery without adjuvant RT but then after a rise in PSA had HT and salvage RT six years later. However what might be relevant was the advice of the oncologist when my PSA rose above 0.2 that he saw no point in me having a scan. He said that in his experience scans couldn't be relied on to provide information when PSA was less than 0.5 and that it would be best to start the salvage treatment at a lower PSA.

(Basically, with PSA at 0.3 or 0.4 he wouldn't take a negative scan as meaningful, there would be too much risk in not going ahead with salvage treatment, so there was no point in a scan which didn't guide the clinical approach).

User
Posted 04 Jul 2025 at 21:15

PSA today 0.7 so it's increasing quickly.

It was only prostate bed that was irradiated Franci. I'll ask on Wednesday about MRI for spine as the recent one was pelvis.

Thanks for your input.

Edited by member 04 Jul 2025 at 21:16  | Reason: Typo

User
Posted 05 Jul 2025 at 00:09
So he still has the option of wider pelvic nodes irradiation.

I would also ask about the benefit of early chemo.

 
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