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Bone Scan & CT Scan vs PET Scan?

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Prostate Cancer
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Posted 2/8/2020 5:59 PM (GMT 0)
I have a bone scan and a CT scan scheduled for the 13th, but just read in Scholz's book with 30 experts, that PET scans do a much better job of finding tumors. I have EDS, Ehlers-Danlos Syndrome, which has led to a good amount of arthritis in my hips. One expert, Dr. Almeida, says arthritis can be mistaken for metastasis with bone scan. Also says:
"Traditionally, doctors have relied on CT and Bone scans. However their accuracy is quite disappointing. PET scanning technology is revolutionizing the way prostate cancer is treated."

Could this be another insurance coverage limitation, lack of PET equipment locally, or just my uro's ignorance?
Posted 2/8/2020 6:18 PM (GMT 0)
Probably insurance. The PET machines are generally plentiful and most urologists follow standard of care protocols which include these scans at this time in your treatment sequence. Often the PET has to follow some other identifier or risk indicator. Bone scan and CT are cheap compared to the PET.

As long as the radiologist knows about your arthritis it can be considered. The CT will basically check organs in the trunk and can provide some info on suspicious lymph nodes, seminal vesicles size and the like. With your PSA it is doubtful anything would be significant to show up but you don’t know.

I think the best value of these basic scans no is to have a baseline for potential future scans and to identify suspicious areas that warrant closer investigation.
Posted 2/8/2020 11:10 PM (GMT 0)
PET/CT scans with the normal contrast agents for other cancers does not work for prostate cancer and have not been approved. There have been special radioactive agents developed (ie: Auxium) that do work better but they are difficult to obtain, have a short shelf life, and not widely available. Obviously, the cost becomes a big issue with more expensive scans and people are still have trouble getting prostate MRI scans covered at much lessor cost. Maybe someday it will be a standard screening tool and available at every hospital or center.
Posted 2/8/2020 11:27 PM (GMT 0)
Yeah... The new Auxium scans are really drilling down to finding metastasis. I had one post SRT when my PSA went back up to over 0.20 which is the level at which they authorize it. Insurance was not a hangup and paid for it all. Results came back clear... smile

pasayten
Posted 2/9/2020 2:23 PM (GMT 0)
Got the bone scan after a radioisotope injection to see if it had metastasized to my bones, a contrast MRI to see about how big and what the shape of my prostate was. The technician recognized what he saw, we interacted real time. The only questionable bone areas were in my jaw, likely due to an infection I had there.

The contrast MRI showed my prostate in enough detail to easily see the 2 major extraprostatic projections.

Got another bone scan 2 years ago, no difference smile that qualified me for an axumin PET scan. Of course, that comes with a CAT scan. We got pictures of two approx. 15 mm diameter pelvic lymph glands that glowed like stars in the night sky. Comparing those pictures with the pix from my 70Gy radiation therapy 7 years ago shows that the likely mets are in areas that were not hit with the first round of radiation.

That means I have a shot at getting more radiation and maybe kicking the can down the road a bit further. smile

That's my story, though as always, your mileage may vary. wink
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