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PSMA PET Scan

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Prostate Cancer
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Posted 8/8/2022 8:24 PM (GMT -5)
Dad just had his second PSMA PET scan today. Praying for good results. His last one was November 21 and he had a spot in bladder neck and 3 very small spots on ribs. He started Lupron Dec 1, 2021. Had spot on bladder neck removed in January. Urologist took another look in bladder again 5/4/21 and saw the same spot but much smaller. Removed end of May. Dad bled a lot and ended up with a catheter for almost 3 weeks until the bleeding stopped . PSA has been less than .13 all this year. I’m very nervous for results since the bladder neck spot regrew after being removed in January. Even tho it was smaller how did it grow back while on Lupron?? If his PC was resistant to Lupron would his PSA still be low?
Posted 8/8/2022 9:19 PM (GMT -5)
It can be. There is a variant of PCa that doesn't emit much PSA but can be aggressive. I am not very familiar with it, but others will chime in I am sure that have more information about it. I wish your dad all the best.
Posted 8/9/2022 11:03 AM (GMT -5)
Oh no. I know his PSA was only around .3-.3 when the PSMA PET scan (11/21)showed the spot in bladder neck and the 3 very small spots on ribs. He’s been fighting PC for about 10 years now.
Posted 8/9/2022 1:19 PM (GMT -5)
I know it's so scary! I believe it is called small cell prostate cancer. You can google it. It is more aggressive and emits low PSA.
Posted 8/9/2022 1:32 PM (GMT -5)
Yes, small cell.
But neuroendocrine also does not emit much if any PSA or PSMA.

So says Dr Kwon
Posted 8/9/2022 1:50 PM (GMT -5)
Below is the info from the first spot that was taken from bladder neck


Diagnosis
PRELIMINARY DIAGNOSIS:
A.
BLADDER TUMOR, TRANSURETHRAL RESECTION -
1.
ATYPICAL SMALL ACINAR PROLIFERATION (SEE COMMENT)
2.
CONSULTATION IS PENIDNG, AND WILL BE REPORTED IN AN
ADDENDUM
COMMENT:
The lesion shows some glandular areas and abundant spindle cell areas.
Immunostains are performed with appropriate controls. The glandular cells of interest
are weakly to moderately positive for PSA/PSAP, and negative for P63, CK7, CK20,
and GATA3. The spindle cell areas are most consistent with stromal hyperplasia with
reactive changes.
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