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Choline C11 and Axumin F18 PET or CT scans? Any near Charlotte NC??????

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Prostate Cancer
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Posted 3/7/2017 11:16 PM (GMT -5)
Hubby finally went to an Oncologist. We really like him and hubby is changing his HDT shots to this new doctor and will not be seeing his urologist anymore. The new doc feels that hubby is definitely having recurrence of his pc. And wants to begin treatments ASAP. He has also has referred him to a radiation oncologist for a consult and to get some more tests. I want hubby to get one of the new 'more sensitive' CT or PET scans that use Choline (C11) or Axumin (F18) or others that I may not have yet read about. I've done a number of searches, but did not see any centers in our area that are using them. That doesn't mean they don't, though. We live in Charlotte NC. Hubby said he'd rather not go out of our area. I want to be prepared for the radiation oncologist's appointment.
Does anyone know of any hospital (or other place that does PET or CT scans) that uses one of these or other newish things that would show micro-mets? I strongly suspect (as does the new oncologist) that he has possible bone mets and possible sinus mets.

I would also appreciate hearing from anyone that has any experience with these or other new imaging.

Thanks for the info and support in advance!!!!!!!!!!
Posted 3/8/2017 5:59 AM (GMT -5)
There aren't any clinical trials for a PET scan where he'll be able to get an Axumin or a PSMA PET scan or a C-11 scan while he is taking hormone therapy - nor would any of them be useful. Maybe he can get one if he takes a vacation from his hormone therapy and his PSA gets up high enough. The limits of detection are about 4 mm. I'm not sure what you mean by micrometastases, but any smaller than that will not show up. There are none that I know of in the Charlotte area. You can call Duke or Wake Forest to see what they may be working on, but they haven't announced any yet.

You should think about what difference it might make in his treatment even if he had one. He seems to be responding great to whatever he is doing now.
Posted 3/8/2017 6:32 AM (GMT -5)
The problem is his PSA has risen almost every test he's had ( every 4 months ) for the past year and a half. He is high risk (G9. And known lymph nodes mets immediately after surgery). I read several studies that G8s and above who have high G scores and high PSA scores after surgery ( above 0.1 and his was 3.8) are now considered at biochemical resurgent at 0.03. He is now 0.04. He has been at 0.00 for almost 3 years prior to this continual rise. Doubling time is now estimated st 6 yo 9 months. Oncologist is very concerned. I am too. Especially as he is showing signs of possible bone mets. From what I'm reading, axumin is now approved and there are 'regular' clinics and hospitals using it as treatment. Same for C11. I know of a few places using one or both such as Mayo, Emory in Atlanta, Loyola, John Hopkins, and others. Not really wanting clinical trials necessarily.
Posted 3/8/2017 10:31 AM (GMT -5)
Dear worried
I've looked into these scans ad nauseoum. My RO Dr Dattoli, had advised waiting until PSA is closer to 2.0 before getting the axumin scan ( to improve accuracy )which is becoming readily available at many locations. I'm getting mine done at Sand Lake Imaging in Orlando thru referral by Dattoli which is Medicare approved for reimbursement. There's a rad clinic near me in Savannah that does the axumin scan but Medicare has not yet approved reimbursement for them. If you google axumin you'll find that it's been licensed for use to a company (Blue Earth, the producer and Siemens the distributor) by its discoverer at Emory in Atlanta. Each provider needs to get Medicare approval or it's out of pocket. Not sure about private insurance. Blue Earth has a number you can call to find locations where axumin is available. C-11 acetate is used at a number of places but as clinical trials With lots of restrictions. C-11 choline is at Mayo only in Rochester. Not sure if it's via clinical trial.
Bob
Posted 3/8/2017 12:06 PM (GMT -5)
You seem to be missing the point. There are no scans that will pick up anything while his PSA is 0.04, which I assume is because of his hormone therapy. You wrote that his post-op PSA was 3.8 and his PLND detected LN mets, so you've known that since 2012, and you have obviously decided not to have salvage radiation for him.

So what exactly do you think any scan will do for him? He is responding very well to the hormone therapy he is already taking.
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