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Thoughts about the PSMA PET scan??

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Posted 12/9/2019 5:39 PM (GMT 0)
Greetings, My PSA sky rocketed last month so my PA sent me to see a urologist with Siteman cancer center in St Louis. He suggested I might get a PSMA PET scan. Believe me I've had many scans over the last 6 years, and its no big deal, but I am concerned because this scan, and the tracer they inject is new.

Any thoughts???
Posted 12/10/2019 3:09 AM (GMT 0)
Sorry, can’t help much with this. The tracer has a few years under its belt now so I assume that the people offering the scan could advise you of the side effect profile to date, if any. Good luck with your quest and maybe others here can help answer your question.
Posted 12/10/2019 3:46 AM (GMT 0)
I had a PSMA scan to qualify me for the Vision trial..The radioactive tracer they use (Ga-68) has a VERY short half life..Something like 68 minutes ? So it has to be made nearby the site where it will be used and delivered as quickly as possible.. The place that did my scan could only do 3 scans a day because of the very tight scheduling window and coordinating with the nuclear pharmacy that made the stuff and the motorcycle courier who delivered it...Needless to say, these scans are VERY expensive..
Posted 12/10/2019 1:30 PM (GMT 0)
Fairwind, thanks for the reply. Looks like you've had a rough go. I suspected the cost would be extremely high. I will investigate that, if and when I decide to have the scan. I'm having another PSA test this week. I was expecting the siteman urologist would recommend I start ADT, because that was the direction the folks at MD Anderson was heading. I've done a lot of research about everything prostate cancer, and the one thing I've learned is that the treatment shouldn't be worse than the disease.
Posted 12/10/2019 9:01 PM (GMT 0)

10drum said...
.......one thing I've learned is that the treatment shouldn't be worse than the disease.

Excellent....I wish more physicians learned the same lesson!
Posted 12/10/2019 9:15 PM (GMT 0)
I had four PSMA PET/CTs and three PSMA PET/MRIs done so far. I am in Germany and my insurance pays for these. No side effects.
E.g. UCSF and UCLA offer these scans, one is about $ 2.500 as far as I know.
Posted 12/13/2019 3:10 AM (GMT 0)
I have had one PSMA Gallium scan. I had no side effects at all. Any injected medication could possibly cause an allergic reaction but that would be something completely unpredictable and unexpected.
Posted 12/29/2019 2:51 AM (GMT 0)
Hi 10drum. Your PSA is high enough that a 68Ga-PSMA-PET scan should be able to locate the source(s) of your BCR, whether the prostate fossa, regional lymph nodes, and/or distant mets. This scan is leading to changes in treatment decisions in a good percentage of cases. Previously SRT was directed at the fossa almost by default. The scan result can also aid a decision about ADT.

Note that not all men produce PSMA -- I believe a test is run before the scan, but others here who have had the scan can speak to that. (There are equally sensitive alternative scans should you be a non-producer.) The equipment has to be correctly calibrated, because other body tissues also produce this antigen, especially the lacrimal and salivary glands, but prostate cells produce more. (My uro mentioned at my last visit that this can lead to severe dry eyes and mouth in some cases of PSMA-based treatment -- theranostics, which combines disease treatment with diagnosis.)

If it is the Gallium PSMA scan your doc has in mind, one drawback of this radionuclide is that it's eliminated via the kidneys, so the entire bladder "lights up" on the scan. This can make it difficult to discern PCa lesions at the bladder neck.

Djin
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