What is the best scan to locate Prostate Cancer that esacped?

Current thinking is that microscopic cancer cells escaped pre surgery.  So meeting with Onocologist Tuesday at Mayo.  He is young and got his fellowship at MD Anderson so he must be decent.  Prior to any more decisions though I want the best scan available to see if anything has landed since my bone scan 8 weeks ago.

Thanks for any advice.

Jeff, options on scans are aplenty. They each have their purpose, it is not an easy process to determine or decide upon.

I don't know if you have seen my travels but here is a brief recap.

Had surgery Sep 09, first PSA test afterwards was .40. Started radiation therapy in Dec 09 when PSA was .67.

May 2010, a F18 Pet Scan found a suspicious area that could not be definitely ruled a MET or not. But because of its location (femoral head at left hip) we went ahead and radiated it.

My most current PSA test in Feb 2012 was 13.3. I have had numerous scans and am involved in a diagnostic clinical trial at the National Cancer Institute using F18 Pet/CT scans to find the smallest of activity and mets. To date they can find nothing that tells me what is causing the continued rise in PSA.

I considered at one point Dattoli and the feraheme scan at Sand Lake Imaging (Orlando) to see if they could find something in my nodes. I decided not to have the scan for a couple of reasons. First, Feraheme is an approved drug for treating iron deficiency anemia. There are some potentially significant side effects possible with the drug.

But mainly, I chose not to have the scan because Dattoli, Myers and Sandlake Imaging are skirting the edges by using it to scan for PCa. It is NOT APPROVED by the FDA for this type of scan use. It just so happens that if you have the drug and then a scan, it will light up the areas of suspicious nodal activity that could be PCa. I just figured that if there was that strong a proven case for this scan, somebody would have tested it and put it forth to the FDA for clinical trial approval. As best as I can determine, nobody has done that yet.

I believe that there have been two brothers here on HW that have gone through the Feraheme scan, but they have not posted much about the results or what they did afterwards. Maybe they will come forward on this one.

I know that this does not really answer you primary question, I just thought it was info you might like to file away for your thought processes as you go forward.

Best of luck to you,

Sonny

Husband had C-11 Choline scan at Mayo in Rochester, MN in November 2011. At the time his PSA was 2.01 which was up from .8 in early September. Nothing was found on the scan. He also has a rectal color doppler ultrasound 3 to 4 times a a year which identifies any change in blood flow in the area of the prostate bed which may indicate initial stages of tumor growth in that area.
There is also a C-11 Acetate scan which uses a different agent, (acetate). I'm sure you can search online where to get this.
Here is a post from last November that you might find interesting:
https://www.healingwell.com/community/default.aspx?f=35&m=2217367&p=2

Trying trying to stay positive but really pissed and second guessing the surgery.
Just had so much good news until the PSA.
Trying to man up for the next few tests.
I will have either Chlr Pet or go to Dattoli.
Not going to sit around and sit idle.

Thanks for all the advice.

Trying trying to stay positive but really pissed and second guessing the surgery.

One of the first things that we all learn the hard way is that there are no certainties in PCa. Unlike many cancers, there is no "absolute" or "tried and true" solution that fits everyone.

There is no reason to second guess the surgery. It is done. You have decisions to make about how to proceed that are much more important than thinking about what might have been.

Be positive because you want to be (and I will offer my opinion that you need to be, as things progress). We are all in that same boat, regardless of what our first treatment was. We want to be part of those large percentages of patients that our doctors told us do great.

I'm now at the HT decision point. Arguments for, arguments against. That debate is my priority now. Well, that and getting my taxes finished.