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AXUMIN SCAN

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Posted 8/15/2018 5:51 PM (GMT -5)
My husbands radiation Onc. recommended the Axumin scan to to detect to find prostate
cancer across local and distant sites.

He had a traditional CT and and bone scan a month ago.
CT scan showed a possible met. but nothing unusual showed on the bone scan.

The Oncol. mentioned there are 2 other scans as well but aren't approved by insurance coverage yet.

Has anyone had this AXUMIN scan and if so were the results clearer than traditional scans.

Thank you,

BOOGEE
Posted 8/15/2018 6:27 PM (GMT -5)
Axumin's detection rate is poor if PSA is <1.0. Others more knowledgeable than I will be around soon, I'm sure, with more detailed and accurate information.

Before you do an Axumin, check very carefully with your insurance provider about what the cost to you will be. My insurance (Blue Cross Blue Shield) covered the PET scan with a nominal co-pay, but only 70% of the cost of the imaging agent -- which in this case was nearly $4,000. I was stuck paying about $1,000 out of pocket. And as I learned later, my PSA was too low (0.10) for Axumin to pick up anything. Waste of time and money. Word to the wise.
Posted 8/15/2018 6:42 PM (GMT -5)
Axumin is FDA and Medicare approved for patients who have a PSA>0.2 after prostatectomy. At your PSA of 0.4, you have about a 38% chance that it will detect any mets.

More to the point, what would you do about it?
Posted 8/15/2018 6:52 PM (GMT -5)
My RO ordered an Axumin scan for me; my PSA was 0.4. No mets detected. PSMA scan is somewhat more sensitive, but is not covered under Kaiser. RO said that even if I got the scan, he wouldn't use the results since it's considered an experimental procedure.
Posted 8/15/2018 7:48 PM (GMT -5)
TA,
When you say Axumin has 38% to detect Mets at this lovel, you mean
My MRI who detected Mets at .36 is better than axumin? I can’t travel to NIH, is there
Any scans available in NY or at MSK that will be very helpful to me please?
You ask “what would you do about it”. Can we radiate the met spots to at least
Delay the disease progress? Thanks
Posted 8/15/2018 9:29 PM (GMT -5)
AK123

That's what our radiation Oncol. would do.
My husbands past scans (traditional) have in the past showed mets so he has had radiation to his rib, spine and pelvis over the past 3 years

Oncol. says if 3 or less mets. are found he can do radiation so finding mets early is the key.

Husband had been on Degarelix for the past 5-6 years. We changed Oncol. as he didn't want to change him back to Lupron which he was on the first couple of years after RP.

The Oncol. we had been seeing said he was waiting for him to reach 2.0 or above before changing and treatment plan.
Our Radiation Oncol said he didn't like that as if he reached above 2 there may be too many mets to radiate.

Our new Oncol. put him back on Lupron, so time will tell.

I need to update his sig. and will do so as soon if we can see if the Lupron is working.

BOOGEE
Posted 8/15/2018 9:31 PM (GMT -5)

Ak123 said...
..... Can we radiate the met spots to at least
Delay the disease progress? Thanks

I'm no expert but I believe the answer is "no". Unless there are less than 4 spots(maybe 5,may depend on Doc). There is no cure with metastasis, only control. You radiate met spots if they are causing pain. Lupron will shrink the mets and zytiga too. I know everyone complains about ADT but I'm glad to be on it and doing well.
Posted 8/15/2018 9:36 PM (GMT -5)
Saipen.

Did you mean the scan isn't reliable if the PSA is less than 1.0.

My husbands PSA is now .8. His testosterone is 24 down from 58 and that was when he was on degarelix.
So it has dropped with 1 lupron injection. Just had the second injection 3 weeks ago.

BOOGEE
Posted 8/15/2018 10:37 PM (GMT -5)
Boogee--

My statement about detection rate being poor at PSA <1.0 waters down some specific information from Tall Allen's blogspot. In particular:

"Even the newly approved Axumin PET scan only detects cancer in 38% of patients if their PSA is in the range of 0.5-1.0 ng/ml." Feb. 24, 2018.

"The newly approved Axumin PET scan, now becoming widely available, has good detection rates (89%) when PSA is above 2.0 ng/ml, as it is at the time of a biochemical recurrence after primary radiotherapy." Sep. 3, 2017.

Go to /pcnrv.blogspot.com for TA's Prostate Cancer News, Reviews & Views, and type "axumin" in the search box.

Apologies to TA if I've misunderstood something by taking it out of context.
Posted 8/16/2018 12:46 AM (GMT -5)
SP-

Thanks for catching that - my bad - it was an error on my part, which I've just corrected. It should have read "...0.2-1.0" It was actually anything below 1 ng/ml on a conventional PSA.

But I agree with you - 38% chance of finding something isn't very good. And what would BOOGEE do differently if it found something or if it didn't.
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