Looking for the name of a test.

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DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 8/19/2009 9:43 PM (GMT -6)   
Hi Everyone,
 
Could anyone here tell me what the test is called that they give you before salvage radiation to highlight where the cancer cells are? All I know about it is he has to get a liquid something three days before and then go in for some kind of scan.
 
Thanks for reading. Keeping the group in my prayers.
 
Dana


SO diagnosed 4/15/09 age 47
1/15/09=PSA 10
Dx 4/15/09=Right side= Gleason 4+4=7, 40% involved, 5 out of 6 cores positive, perineural invasion present
Left side+ Gleason 4+4=8, 60% involved, 5 out of 6 cores positive, no perineural invasion present
T2c
5/14/09=Robotic surgery at Cleveland Clinic by Dr. Gong
pre-op PSA 15, MRI shows extracapsular penetration
Pathology 5/21/09-T3a, N1MX, positive margins, 1 out of 13 lymph nodes positive, left nerves spared
7/7/09- pad free
7/10/09- PSA 1.1
7/25/09-PSA .2


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 8/20/2009 7:54 AM (GMT -6)   
I don't know Dana...most of the nuclear scans that I am familar with only require something like an hour, maybe as long as three hours before performing the scan. Three days...that seems like a long time between infusion and then the scan. Even the most common PET scans used for mapping cancer cells, the isotope is injected only about an hour beforehand.

Let us know what of test this is when you find out...I am very curious to know myself.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08


DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 8/20/2009 9:13 PM (GMT -6)   
It's called a ProstaScint scan.
 
Dana
SO diagnosed 4/15/09 age 47
1/15/09=PSA 10
Dx 4/15/09=Right side= Gleason 4+4=7, 40% involved, 5 out of 6 cores positive, perineural invasion present
Left side+ Gleason 4+4=8, 60% involved, 5 out of 6 cores positive, no perineural invasion present
T2c
5/14/09=Robotic surgery at Cleveland Clinic by Dr. Gong
pre-op PSA 15, MRI shows extracapsular penetration
Pathology 5/21/09-T3a, N1MX, positive margins, 1 out of 13 lymph nodes positive, left nerves spared
7/7/09- pad free
7/10/09- PSA 1.1
7/25/09-PSA .2


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 8/20/2009 9:24 PM (GMT -6)   
My radiologist said he does not like it. It has a very high false positive rate. (But pretty low false negative). So if you have a "hot spot" in pelvis and say your arm, do you conclude you have distant mets? There is little you can do with the results, but it can cause a lot of anxiety.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/21/2009 7:46 AM (GMT -6)   
My latest radiation oncologisti mentioned the same test and said that he didn't like to give it, no way to draw an accurate conclusion.
 Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, 8/14 met with Rad Oncl, still talking option, 8/18 - had laser scope surgery to clear blockage, now on Catheter #7
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 8/21/2009 8:03 AM (GMT -6)   
Thanks Dana....guess I misunderstood the three day part. The first scan is done about an hour after the injection and then a second scan to compare to the first scan is done a couple of days later. Doctors seem to be on the fence to whether they recommend this particular scan or not, however the scan can be very useful. The more data, the better the analysis. So this will be just one more tool for the docs to use in deciding what to do next. BTW, my doc uses this test also. He says he wants to look at everything before making any decision as important as the next step in battling this disease.

Good luck and keep us all posted.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 8/21/2009 1:42 PM (GMT -6)   
I am totally facinated by this test. I wonder why we don't hear more about it. Sounds like it is more promising than the bone scan or CT scan we get after diagnosis if it really can pick out PSA producing cells. My arthritis showed up more than anything else on the scans. Had to do an x-ray of my foot to rule out a tumor there.

I certainly am going to talk to my radiation guy on my next visit.

Thanks for asking about it !
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 8/21/2009 2:27 PM (GMT -6)   
Prostascint with or without CT fusion is highly inaccurrate. It is used to diagnois lymphnode involvement. Bone scans are completely different. There is also DYE Enhanced MRI that uses an imaging agent to see hot spots in the prostate or prostate bed. The best test for Lymphnodes is the Combidex MRI. Any CT scan will only identify large lymphnodes (over 10mm) if a node is enlarged it is considered possibly involved with PC. Bone or CT scans will usually always be negative unless the psa is over 20. The isotope used in bone scans doesn't bind to the PC cells very well; old injuries show up as hot spots.
The best tests for PC are the endo rectal MRIS that can spot PC in the outer prostate, in the bed and can see extraprostic extentions. The color doppler is much better at seeing the internal parts of the prostate such as the transition zone. Combidex is the best for identifying lymp node PC. There is promissing new technology that fuses MRIS, color doppler and dye enhanced imaging to get a more complete picture of the prostate.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 8/21/2009 2:47 PM (GMT -6)   
John,

I am thinking about salvage radiation. Most IMRT salvage jobs go towards the bed, because there is some logic there.

If something like Prostascint could identify other collections of PC cells, that would be fabulous. In my case, all lymph nodes were negative, at least at the time of surgery. With a G9, I am expecting it to pop up somewhere. If only they could find it and zap it.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 8/21/2009 2:54 PM (GMT -6)   
John,

I just want to add also....the idea of using isotope antibodies that will attach to prostate cells is very useful when the prostate has already been removed. The dual scan will help identify areas of concern or potential location for recurrence at very low levels of psa. If the markers show up outside the bed area, then it is possible, but not conclusive that there is some systemic disease. This scan by itself is not to be the all inclusive, but rather an additional piece to the puzzle of where the psa is being generated. Are there other test, yes. Are they any better or worse...all depends on the person reading the scans.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 8/21/2009 5:53 PM (GMT -6)   
Les,
What's the name of the test? Is it Dye Enhanced MRI? I've heard of another blood test that is supposed to identify Prostate Cancer cells; I think Dr Meyrs had this done.
Good life, You may want to contact UCLA, radiology dept. I heard they were working on some new scanning technology for PC.

JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT

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