PSMA/ct scans in the US

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CADguy
Regular Member


Date Joined Dec 2014
Total Posts : 104
   Posted 11/12/2016 12:38 PM (GMT -6)   
I am trying to determine if there are PSMA/ct scans available as standard care in the USA. Has anyone had PSMA/ct scans in the US?

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8610
   Posted 11/12/2016 2:34 PM (GMT -6)   
It's not standard of care anywhere. None are FDA approved (C-11 Choline and fluciclovine are FDA approved but are not PSMA scans). They are available in some clinical trials, depending on your diagnosis.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEs
my PC blog

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7180
   Posted 11/12/2016 2:41 PM (GMT -6)   
CAD:

I had looked into this, and they are still only in Clinical Trials. I think U of Mich is going to start a major one soon -- they are cementing funding.

I think next time I do scans (1 or hopefully 2-3 years from now), they will be FDA approved.

Mel
PSA-- 11/09--4.19 .Biop.11/30/09.G 4+3.RP: 1/26/10. G 4+3. PNI,EPE, Margin, No SVI..100% cont. by 3/10. PSA: 3/10/10-0.01; 6/21/10--0.02. ,3/1/11--0.27. SRT May '11, PSA 7/11/11-0.60; 8/11/11-0.75; PSADT-3 mos.; PSA 17.55 3/13 so started Lupron/Casodex. PSA 0.57 0n 4/20/13; 0.07 on 5/30/13. 0.03 on 7/26/13.Undetectable since then. On HT vacation since Feb, '14. PSA 0.04 6/16/14

Bobby Mac
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Date Joined Mar 2016
Total Posts : 657
   Posted 11/12/2016 3:50 PM (GMT -6)   
CAD-

I had the 68 Gallium PSMA PET/CT via a trail this summer at the UCSF - that study may still be open? Only requirement was a rising PSA score.

My insurance covered it, but you should check to see if your insurance will do the same.

I was booked and ready to travel to Heidelberg, Germany, who has has had this scan for years, if I did not get into a study. Cost was going to be 1,900 ERO plus, of course, travel costs.

Bobby Mac
Age: 69, 69 at PC dx, PSA 6.7 Biopsy: 2/16 13 of 14 Positive, 2-99%, GL 7 (4+3) - RALP 4/20/16 Pathology:Non-Focal EPE, 2 positive margins, Gleason 4+3=7, involving 50% of gland, prostate weight 31.5 g, Stage pT3a N1, nodes 2/10, right side positive, Casodex two months, Lupron 8/17/16, uPSA 6/1/16, 2.41, SRT started 10/27/16, PSA 6/16/2016, 2.6, 7/12/16, 2.2, 8/11/16 .6, 10/10/16 <0.1

Cyclone-ISU
Veteran Member


Date Joined Oct 2014
Total Posts : 956
   Posted 11/12/2016 7:39 PM (GMT -6)   
Hello CADguy,

Always good to hear from you --- I've always been thankful for your friendship, here on the website, over time.

I was wondering if a CHOLINE-PET scan might work out for you, instead ?

If so, there are several of us here who have traveled to Mayo Clinic in Rochester, Minnesota, to have the CHOLINE-PET scan.

I've traveled up to Mayo Clinic three times for the CHOLINE-PET scan, and I'm booked for a return consultation and follow-up CHOLINE scan in the New Year, after the holiday season.

I've got several friends who have done the same thing --- they have also traveled to Mayo Clinic, following a recommendation from their local doctor --- in the interest of additional imaging to track minute traces of prostate cancer.

I was just trying hard to think of a possible "Plan B" in regard to your message today.

You've got my thoughts and loyal support every step of the way, CADguy !

Handshake, friendship, brotherhood,
"Cyclone Team Fan" ~ Iowa State University (They Won Their Basketball Game AND Their Football Game This Weekend !)
PSA At Diagnosis In Year 2013 : 138
Initial Diagnosis: Advanced Prostate Cancer, With Metastases In Both Lungs
Age At Diagnosis: 48 years
ADT Treatments: LUPRON, FIRMAGON, and currently ZOLADEX
Subsequent Treatments: Chemotherapy Treatments (TAXOTERE) & now ZYTIGA
Additional Medical Consultant - Dr. Eugene KWON - Mayo Clinic
PSA Level: Currently < 0.10, With Treatments Ongoing

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3002
   Posted 11/12/2016 9:24 PM (GMT -6)   
I've had a few DCFBC PSMA scans at NIH as part of a trial. Other than that just normal f18 Pet/Cts.
11/09 Dx at Age 44 ----- 4.03
12/09 DaVinci Surgery,t3b,g9 <.05
2/10 Adj. Radiation ----------- <.05
3/11 PSA Rise/Scans/Spot ---- .09
on Pelvic Bone
4/11 HT/XGEVA/Spot Radiation -- .06
2011-2012: ADT3: 15 months
2013-2015: ADT3 VACATION #1: 36 Months

George_
Regular Member


Date Joined Apr 2016
Total Posts : 395
   Posted 11/13/2016 1:22 AM (GMT -6)   
A PSMA PET/CT has the highest sensitivity though.

At a convention Prof. Amthauer presented the following detection rates depending on the PSA value:
PSA Level           18F-Cholin          68Ga-PSMA
<0.5ng/ml           12.5%                50%
0.5–2.0ng/ml        36%                  71%
>2ng/ml             63%                  88%

Apparently, if you are on ADT a PSMA PET/CT will work at much lower PSA values. I had one done at 0.09 ng/ml and it showed the same mets as the one I had done at 19.9 ng/ml before.

However, if you see all your mets you have to decide whether you will treat them and how that can be done.

George

Chask
Veteran Member


Date Joined Jun 2014
Total Posts : 509
   Posted 11/13/2016 2:00 AM (GMT -6)   
Though outside the range of the original question, it is maybe worth mentioning that we have at least 2 or maybe 3 centres in Australia where we can get G68 PSMA scans, at a cost (somewhere between A$800 and A$1,000 I think).

I am having my next PSA read and full bone and pelvic scan performed in next few days before seeing my oncologist in 10 days time. The outcomes from all that may (or may not) determine whether a PSMA scan could be of value.

Chas
Age 68 at Dx
10/08 to 03/13 PSA 2.9 < 7.1
07/13 Bx 4+ cores from 12 GL 4+5 Scans clear
08/13 LRP
Path: Gl 4+3 PNI, bladder mgn +, SV, LN Neg, pT3a N0 Mx
10/13 PSA .03
11/13 PSA .07
12/13 12 month ADT
Continent
01/14 37 sess of RT
05/14 Incontinence back
11/14 Retentive due to RT nerve damage. SPC installed
12/14 ADT Break
05/14 - 09/15 PSA <.01
12/15 .01
03/16 .03
O6/16 .09
09/16 .53!!

Tomson
Regular Member


Date Joined Mar 2015
Total Posts : 58
   Posted 11/14/2016 5:47 PM (GMT -6)   
I had a Gallium-68 PET/MRI scan at UCSF on October 7, 2016. It took me over a month to get a date for the scan as a UCSF PCa patient with recurrent PSA after prostatectomy. I was told that Medicare would cover the MRI scan but that I would have to pay $1,600 to cover the Gallium-68 radiotracer which is not yet FDA approved and, therefore, definitely not covered by Medicare. The radiation tech told me that UCSF was one of two sites in the U.S. who are compiling the experimental data to support FDA approval which is extremely likely.
Dx 2/1/15 (age 65)
8/14 PSA 6.4
2/15 PSA 5.45 (8% free)
Bx 1/26/15 8/12 cores; 3 cores G7 (3+4); 5 cores G6 (3+3)
DRE: nodule palpable
RALP (UCSF) 4/8/15; nerves spared; sling made from vas
Post surgical pathology: G7 (3+4, tertiary 5); ECE-, SM-, LN-, SV-; PNI+
Decipher: 6.6% 5-yr metastasis; 6.3% 10-yr PCa mortality
PSA 5/15, 8/15, 11/15: <0.015; 2/16 .031; 5/16 .053; 8/16 .107; 9/16 .129

Tomson
Regular Member


Date Joined Mar 2015
Total Posts : 58
   Posted 11/14/2016 5:49 PM (GMT -6)   
I was told that CT rather than MRI would be used only if I could not do MRI because of, say, having a pacemaker.
Dx 2/1/15 (age 65)
8/14 PSA 6.4
2/15 PSA 5.45 (8% free)
Bx 1/26/15 8/12 cores; 3 cores G7 (3+4); 5 cores G6 (3+3)
DRE: nodule palpable
RALP (UCSF) 4/8/15; nerves spared; sling made from vas
Post surgical pathology: G7 (3+4, tertiary 5); ECE-, SM-, LN-, SV-; PNI+
Decipher: 6.6% 5-yr metastasis; 6.3% 10-yr PCa mortality
PSA 5/15, 8/15, 11/15: <0.015; 2/16 .031; 5/16 .053; 8/16 .107; 9/16 .129
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