C-11 Choline PET-CT scan

New Topic Post Reply Printable Version
31 posts in this thread.
Viewing Page :
 1  2 
[ << Previous Thread | Next Thread >> ]

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7665
   Posted 9/21/2011 11:56 AM (GMT -6)   
I am seeing for a third time a presentation of the C-11 Choline PET scans. These are not normal PET scans. Choline is a new contrast that is providing a new and exciting way to detect metastatic prostate cancer in cases with PSA as low as 1. Much has stated here are HW about Combidex and Faraheme based scans for lymph node detection. The problem is that they stop there. C-11 Choline in a PET scan can show not only micro LN invasion but also micro spreads to bones. There are only a couple places in the US to receive these scans but an open clinical trial is available at Wake Forest University.

Here is that trial information
http://clinicaltrials.gov/ct2/show/NCT00804245

This is a good news bad news post. The good news is in the text above. However, I was a bit perturbed by the presenter from the Mayo Clinic in Rochester MN. Two weeks ago I saw the same presentation by Eugene Kwon from Mayo. At that time I raised a question that I had found an ongoing clinical trial for C-11 Choline PET scans going on at Wake Forest University. Kwon had no idea that this effort was happening. Today's presenter Paul Peller from Mayo was caught off guard when I brought it up again. A top medical industry consultant and the author of the Infolink articles, Mike Scott, is also here and to do a brain check I ran this stuff by him. I asked him why do I know this with a simple search in Google and a major research institute doc. does not? Mike had a two word answer ~ Tunnel Vision...

Ugh...

I have a new discovery in the research of prostate cancer ~ Google.com, seems more docs need to know about it...


Tony
Advanced Prostate Cancer at age 44 (I am 49 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 9/21/2011 9:33:04 PM (GMT-6)


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 717
   Posted 9/21/2011 3:28 PM (GMT -6)   
Tony,
 
If this test is as sensitive as it sounds, imagine this.   If it detects micro metastatic cancer in lets say a few spots, then you could go a head and have those spots surgically removed before they spread and become larger.  This could explain the supposedly organ confined people with recurrence and where it is located.  You could find all the little spots and kill them, effectively treating systematic cancer before it got way out of control.
 
 
 

Post Edited (ChrisR) : 9/21/2011 6:53:28 PM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7665
   Posted 9/21/2011 5:23 PM (GMT -6)   
Chris,
You hit the nail on the head. The reason for this test is for men with high risk disease characteristics to be able to identify where additional therapies may be needed and whether systemic treatment may be needed. Right now you can join the Wake Forest trial or contact the Mayo Clinic and ask for doctor's Eugene Kwon or Paul Peller and see if you can get the scan.

Is it perfect? No. It can't detect a single cell and it may miss tumors that are very small. We are waiting to see the results of the trials and that won't happen until 2012. This was presented at PCRI and again here at the ZERO Summit. So it sounds promising but we can't get over joyed with it. Imaging scans thus far for PCa have been less that perfect...

This is NOT a standard PET scan so just getting one that is already approved is not going to get the benefits of this new contract.

Tony
Advanced Prostate Cancer at age 44 (I am 49 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 717
   Posted 9/21/2011 7:57 PM (GMT -6)   
Supposedly, Purdue University had a similiar sensitive test like this using nanoparticles that was supposed to go to clinical trials last year and it never showed up.  I had the same thoughts about this test.  You could find micro mets and have them removed before they got out of hand.  You could effectively chase the cancer around your body until you got it all.  It's really what we are doing with our prostates, just on a larger level.  I never understood why the Purdue thing never went to trial.  The more sensitive the scans are then the more you can erraticate the cancer.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7665
   Posted 9/21/2011 10:30 PM (GMT -6)   
Chris I don't think this test will have us chasing the cancer around our bodies to the point of eradication particularly in advanced cases. We still need to try to get to the cancer before it leaves it's point of origination. But improved imaging contrasts and technologies may strengthen our approaches in controlling mets and improving quality of life. As the presenter stated C-11 Choline doesn't see one cell it finds pockets of many. We keep looking for that perfect imaging test but we are years away from anything resembling it. Even if we could get digital displays in high enough resolution to map the human body, we won't ever be able to analyze it well enough as it is impractical to examine minute particles to see if the are malignant.

But I remain hopeful that we can keep improving these technologies to the point that they allow us more time and better management. I saw a lot of slides and screen shots. It certainly is interesting. These are the best images I have seen to date... But I'm no doctor...

Still my disappointment rings. Two very established research institutions are studying the same thing completely unaware the other is doing it. Sounds like I turned a stone today that surprised the research doctor. If he was truly unaware that Wake Forest had the same research going on, he is probably getting on the phone tomorrow to discuss it. But the call won't be to Wake Forest necessarily ~ it may be to the manufacturer of the contrast...

Tony
Advanced Prostate Cancer at age 44 (I am 49 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Riviere
Regular Member


Date Joined Jul 2011
Total Posts : 324
   Posted 9/22/2011 7:18 AM (GMT -6)   
An interesting Mayo article that describes the effectiveness of this scan is:
"The Utility of 11C-Choline PET/CT for Imaging Prostate Cancer: A Pictorial Guide" www.ajronline.org/content/196/6/1390.long

Nellie
Age 59 Gleason 9
1/10 PSA 14.7
5/10 Bx: Gleason 3+4
8/4/2010 RRP: Gleason 4+5; Positive Margins, PNI
Incontinence: N/A; ED: 70%
Until 4/11, PSA <.01; 4/11: .01; 6/11: .03
ADT3 started 7/20; WPRT started 8/22

Piy
Regular Member


Date Joined Mar 2010
Total Posts : 142
   Posted 11/1/2011 8:29 AM (GMT -6)   
Tony - You mention that this test is performed in only a couple of places in the country. I'm currently trying to find a facility to perform this scan for my husband. Do you know where it is offered?

Thank you!
Amy

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 346
   Posted 11/1/2011 10:03 AM (GMT -6)   
That trial Tony mentions is for "Newly diagnosed" patients. For those who are fighting a rear-guard battle this trial is not available

Piy
Regular Member


Date Joined Mar 2010
Total Posts : 142
   Posted 11/1/2011 10:11 AM (GMT -6)   
The trial is not available, but the scan is. I know it is offered at Mayo in MN but I'm trying to find out if it is offered at any other locations.

Thanks,
Amy

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7665
   Posted 11/1/2011 10:36 AM (GMT -6)   
Amy the other location that has the scan is Wake Forrest University.

Tony
Advanced Prostate Cancer at age 44 (I am 49 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Piy
Regular Member


Date Joined Mar 2010
Total Posts : 142
   Posted 11/1/2011 11:32 AM (GMT -6)   
Tony - I believe Wake Forest only offers it in the trial which is not recruiting, but I'll double-check.

Thanks for responding!
Amy

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7665
   Posted 11/1/2011 11:58 AM (GMT -6)   
I heard someone else tell me that too. It's likely. What did Mayo say about it?

Tony
Advanced Prostate Cancer at age 44 (I am 49 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Piy
Regular Member


Date Joined Mar 2010
Total Posts : 142
   Posted 11/1/2011 12:12 PM (GMT -6)   
So far I haven't gotten much past the phone-answerers at Mayo but have been able to determine that they do offer the scan. They say that it must be scheduled by our Doctor so I've left a message with our Oncologist's office to assist. I asked if it is typically covered by insurance and got the pat answer that I would have to check with my insurance company, something I am loathe to embark on because I just have a feeling they won't know what I'm talking about. I've left a message with the estimating department at Mayo to try to find out what the cost will be if it is not covered.
I did speak to the imaging dept at Wake Forest and the tech had heard of it but said it's in research and not open to the public which is what I suspected.

I will update my progress.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5912
   Posted 11/1/2011 12:21 PM (GMT -6)   
Piy,
 
If your oncologist is scheduling the test, they may also be able to get an approval decision from the insurance company.
 
At least for my insurance, if I go to an in-network doc, he MUST do the authorization process for any test/surgery he prescribes, or he eats the cost. That doesn't mean they will approve and pay, just that the proceedure must be followed. If it is denied, he did his job, and I get to decide how to proceed. I would expect that any physician's business office will know how to do this.
Moderator - Prostate Cancer
(Not a medical professional)

DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Piy
Regular Member


Date Joined Mar 2010
Total Posts : 142
   Posted 11/1/2011 1:32 PM (GMT -6)   
Thanks 142 - Unfortunately our Oncologist is not in network and did not prescribe this procedure. We asked about it at our last mtg when PSA went up again and he was very interested in having us do it, but I guess we're on our own to get it arranged. I am still asking for their assistance however.

Amy
Dx June 2007 - age 48
davinci RRP October 2007
75% of prostate involved -G9
Positive margin
Scans clear
No detectable mets
SRT - Feb 2008
PSA:
At Dx: 8
Mar 09: 0.4
Jun 09: 0.7
Aug 09: 1.7
Feb 10: .008
Apr 10: .007
Jul 10: .006
Sep 10: .005
Mar 11: .06
Aug 11: .8
Oct 11: 2.01

Commenced Dr. Robt Leibowitz "Three Pronged Approach" protocol in August 2009
Completed chemo Dec 2009

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24280
   Posted 11/1/2011 1:44 PM (GMT -6)   
I am in the process of being setup up for what my oncologist stated was an "advanced PET scan". Perhaps when the arrangements are made, I will know what kind it will be.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Piy
Regular Member


Date Joined Mar 2010
Total Posts : 142
   Posted 11/1/2011 2:23 PM (GMT -6)   
David - I'd be interested to hear so please do keep us posted.

Thanks,
Amy
Dx June 2007 - age 48
davinci RRP October 2007
75% of prostate involved -G9
Positive margin
Scans clear
No detectable mets
SRT - Feb 2008
PSA:
At Dx: 8
Mar 09: 0.4
Jun 09: 0.7
Aug 09: 1.7
Feb 10: .008
Apr 10: .007
Jul 10: .006
Sep 10: .005
Mar 11: .06
Aug 11: .8
Oct 11: 2.01

Commenced Dr. Robt Leibowitz "Three Pronged Approach" protocol in August 2009
Completed chemo Dec 2009

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24280
   Posted 11/1/2011 2:33 PM (GMT -6)   
Amy, will definitely report back when I know the when and how is settled. My doctor wasn't impressed with the lastes MRI, bone scan, and x-rays that were taken this summer. We both know the cancer is there, somewhere, and the PSA is getting higher and higher, and something still has to causing all the severe pain. Sure would like to see an answer to some of this

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 2426
   Posted 11/1/2011 6:53 PM (GMT -6)   
David,

Refresh my memory---where exactly is your pain?
Nov. 2009 Dx at Age 44
Dec. 2009 DaVinci Surgery
Jan. 2010 T3b, G9
Feb. 2010 Adj. Radiation
March 2011 PSA Rise/Scan/Spot on Pelvic Bone
April, 2011 Casodex/Lupron
May 2011 Spot Radiation
Oct 2011 Bone/CT Scan - No new spots; spot is 1/2 as intense (whatever that means)

PSA History:
-----------------
Nov. 2009 4.30
2010 <.05
March, 2011 .09
April, 2011 .06
Oct, 2011 <.05

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24280
   Posted 11/1/2011 7:02 PM (GMT -6)   
jerry:

started in earnest about 14 months ago. deep inside my right hip. over time, spread to first the right lower half of my back, then all of my lower back, and all of my right leg above the knee. i have other pains of course, but those are the areas of constant pain. its rare, even with the meds i am on, that there is ever any total relief for the hip pain. still bad enough to need a cane at all times when walking.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 2426
   Posted 11/1/2011 8:56 PM (GMT -6)   
David,

Pain is bad enough because of the physical discomfort, but I'm sure it works on you mentally as well. When you have pain, it's a reminder of PC, whether it is related or not.

I have aches and pains that I associate and truly believe are directly related even though since day one all of my docs thought I was nuts. I've been amazed how they didn't want to hear about them. My pain is definetely not as bad as yours. Never been more than a 3 out of 10.

Here's my rundown-never a pain at the area of my one spot.

- lower back, both sides...noticed a long time ago I sweat a lot there when working out...never used to.
- tingling sensation in lower back sometimes.
- butt feels like it goes to sleep, discomfort at times
- I feel best when not sitting.

A few months before my surgery I had odd pains in between my thighs at times...docs said not related...surgery took that pain away.

Not sure why I'm saying all this. I guess just to compare notes and perhaps get to the underlining cause and find some relief for you.

My wife has her hands full with pain also (went through a tornado). She gets nerve blocks that seem to really help her. Have you tried that angle?

Jerry
Nov. 2009 Dx at Age 44
Dec. 2009 DaVinci Surgery
Jan. 2010 T3b, G9
Feb. 2010 Adj. Radiation
March 2011 PSA Rise/Scan/Spot on Pelvic Bone
April, 2011 Casodex/Lupron
May 2011 Spot Radiation
Oct 2011 Bone/CT Scan - No new spots; spot is 1/2 as intense (whatever that means)

PSA History:
-----------------
Nov. 2009 4.30
2010 <.05
March, 2011 .09
April, 2011 .06
Oct, 2011 <.05

Concerned4You
Regular Member


Date Joined Dec 2010
Total Posts : 87
   Posted 11/2/2011 10:37 AM (GMT -6)   
I believe this is what Dad had done yesterday. It is a clinical trial through Wayne State University. It took over an hour and the tech alternated between a PET SCAN and CT Scan. His was done pro bono. We have a friend who got us in touch w/a great oncologist and she actually called us about this scan after conflictnig bone scan results.
 
We get the results on Friday from the test done yesterday (or at least we should get them). I will confirm it was the C-11 scan and let you know what we find out.
 
I know it took over an hour to do the scan and Dad had to stay away from young kids for 12 hours afterwords.
 
 
 
 
 

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7665
   Posted 11/2/2011 10:46 AM (GMT -6)   
Concerned,
This was a different C-11 PET-Scan. The key to ask is what contracting agent was used in your dad's scan, In this post we are talking abut Choline.

The C11 PET Scan is not new technology. What is being investigated is whether using Choline is doing better than previous agents and it is my understanding that it is indeed producing very good results. Best yet for PCa.

Tony
Advanced Prostate Cancer at age 44 (I am 49 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Piy
Regular Member


Date Joined Mar 2010
Total Posts : 142
   Posted 11/2/2011 5:19 PM (GMT -6)   
We are scheduled! Eric will have the C-11 Choline PET scan at Mayo in Rochester, MN on November 15.
Our oncologist will have the results within a week.

They mentioned that they have opened up some slots for this test because they may not be doing anymore after December, not sure what that is about.

Amy
Dx June 2007 - age 48
davinci RRP October 2007
75% of prostate involved -G9
Positive margin
Scans clear
No detectable mets
SRT - Feb 2008
PSA:
At Dx: 8
Mar 09: 0.4
Jun 09: 0.7
Aug 09: 1.7
Feb 10: .008
Apr 10: .007
Jul 10: .006
Sep 10: .005
Mar 11: .06
Aug 11: .8
Oct 11: 2.01

Commenced Dr. Robt Leibowitz "Three Pronged Approach" protocol in August 2009
Completed chemo Dec 2009

Concerned4You
Regular Member


Date Joined Dec 2010
Total Posts : 87
   Posted 11/3/2011 8:33 AM (GMT -6)   
Hi there,
 
Yes. I understand the PET/CT is not new but the dye is. We are going to confirm which dye was used. At first I thought it was F-18...but then they told us this was a new dye. His was done pro bono as part of research through Wayne State. He actually had it done at the Children's hospital. Anyhow, the tech told Dad this was only the second one he had done this year since they weren't doing many of them.
 
I'm going to ask for a copy of the report to see which dye was use. We should have the results today or tomorrow.
 
I'm not sure it was the C-11 but hoping it was!
 
 
New Topic Post Reply Printable Version
31 posts in this thread.
Viewing Page :
 1  2 
Forum Information
Currently it is Friday, October 24, 2014 2:41 AM (GMT -6)
There are a total of 2,250,043 posts in 250,294 threads.
View Active Threads


Who's Online
This forum has 157497 registered members. Please welcome our newest member, wahabch58.
242 Guest(s), 4 Registered Member(s) are currently online.  Details
AshleyP84, Girlie, paulroy, Steve n Dallas


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest  Follow HealingWell.com on YouTube
Advertisement
Advertisement

©1996-2014 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer