PSMA results

Here is the summary impression:
IMPRESSION:

* Prostate: PSMA (+) disease in the anterior mid- zone and apex of the prostate, consistent with primary malignancy.

* Nodes: No tracer- avid pelvic, retroperitoneal, or mesenteric adenopathy

* Distant metastases: No visceral or osseous metastatic disease

What do you guys think? Looks like recurrent cancer in the prostate only. The report lacks RAD or SUV scores so cant tell how likely the cancer is or how aggressive. Seems like mpMRI and biopsy are next.

I'm surprised the report didnt provide PI-RADS and SUV max. It may be available but not in the patient portal. Maybe my urologist or my RO can see it. Otherwise I have my 1st meeting with Duke MO on March 5. I will ask for more information and next steps which I assume will be mpMRI followed by fusion and systematic biopsy. As to Proton not doing its job, it's a disappointment but not a surprise since 30%+ fail. And It could be new cancers.
My regret is I didnt push for PSMA earlier when PSA increased 3 consecutive times in 2020, 2021, 2022. Although a long way from 2.75 needed to satisfy Phoenix definition of BCF, I felt my treatment had failed
I wanted to believe what my urologist was saying about a healthy 25g prostate being capable of producing measurable PSA. My RO was no help either as he is a robot (a very smart robot) insisting nothing should be done until BCF. I might not have been able to get the PSMA without sufficient cause, who knows.
I'm grateful it's confined to the prostate; it could be much worse but options are limited as to curable treatment. My hope now is the PSMA is a false positive (a long shot I know) or biopsy shows Gleason 6 with active surveillance recommended.

Djin, why do you think a gleason following a biopsy might not be possible?