Best scans???

Mel -

68 Ga PSMA scan is superior to any other previous scans- not sure about Axumin?

I discussed with my RO yesterday the C-11 Choline scan - he did not think it was that great.

The PSMA scan trials are going on in Houston and San Francisco, and they are recruiting as long as PSA doubling time is < 12 months.

Bobby Mac

Fairwind said...
Will the results of this scan change your course of treatment in any material way?

Definitely would change my post op treatment. If I found cancer had gone to distant areas, bones or soft tissue, I would not want my prostate bed radiated and would only use ADT. The adjuvant/salvage RT, in my opinion, would be unnecessary treatment.

I am trying to get into one of the two current PSMA trials - failing that, I may go to Germany, where the scan has been used for some years.

Bobby Mac

I have also been wondering which are the best scans. My husband's RO suggested locating and having a PSMA scan, as my husband failed SRT. However his PSA is on the low side for any scan to find cancer. They do not know where my husband's cancer is, as it did not show up on an MRI and a PET scan. The RO is interested in treating any cancer that might show up in his bones or lymph nodes. The RO thinks that the cancer is probably in the lymph nodes. The RO (at MSKCC) referred my husband to a MO at the same hospital for guidance on scans.

The MO suggested the C-11. My husband can get it as part of a clinical trial at MSKCC. The PSMA will be at MSKCC soon, and my husband might be able to get it there at that time. The RO favored the PSMA and the MO favors the C-11. The MO says that the C-11 shows activity more than the PSMA.

My husband's doubling time is not less than 12 months so he would not qualify for the clinical trials in Texas or California. He would have to go to Germany or Israel and pay for the PSMA test. Since it is questionable whether any scan will show cancer at my husband's current PSA, my husband is not inclined to fly to another country to pay for a scan out-of -pocket, unless advised to by a doctor.

JNF:

One would think Mayo would be able to give me straight answers. They just say check with your insurance plan. My Medicare Advantage Plan says they cover everything that MediCare does. I think I'll need pre-authorization, too.
But I'm having a hard time getting definitive answers.

On the Mayo site, it seems to indicate that they do not accept MediCare as payment in full, but again it just isn't clear. Very frustrating.

Mel

Mel, Is it anything that can't wait until January 2017?

If not during annual enrollment switch to Medicare Supplement Plan F that is superior coverage at a higher premium of course.

That would increase the chances of C-11 Choline through Mayo being covered, but of course check to be sure..

In my case I went to Dr. Fabio Almeida at AZ Molecular Imaging and paid $2,500 out of pocket but well worth it since the combination of F18 sodium and C-11 Acetate showed I had been misdiagnosed and did not have bone mets.

So yes it can change one's future treatments as I became locally advanced and treatable with SBRT radiation and Provenge combination rather than stage 4 palliative only.

Both of these C-11's are recommended to be done at PSA>=2.0 but mine was only 0.27 at the time and did identify three micro lymph nodes involved.

Once you go back on ADT, the Lupron could potentially mask any existing mets be they bone mets or LN's. in My case I was already on Lupron/Zytiga and did not want to go on IHT and wait for the half life to expire, but yours is the opposite choice of having the scans before going back onto ADT.

Mel,
Look into the Combidex nano particle scan. I had it 7 years ago and was very impressed. It picks up lymph node involvement down to 2mm, which I think is the lowest of delectable scans. It's only available in Holland, and it's a good vacation too. If you need any more info email me.
JT