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Soft Tissue Met?

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Posted 7/22/2022 4:17 PM (GMT -5)
Soft Tissue (ST) mets are rare with all forms of primary cancers, but are all but uninown with PCa. Recent PSMA came back clean for lymph, organs and bone, but found one ST node about 1.1 cm in right pararectal area. Identified as 75% probably metastatic disease. MO defines the location as “regional.” I am grateful that the scan did not light up like a string of Christmas Tree lights, but the ST aspect feels ominous. Perhaps because it is so rare? Or perhaps, if there is one? Or perhaps because ST mets in other cancers tend to occur in late stage disease? With PSA at 6.01 I was prepared to find image something, but not this. Nothing for it, but to work with my MO and radiation at MSK to determine the possible. But it feels like uncharted waters.
Posted 7/22/2022 5:05 PM (GMT -5)
Which type of PSMA scan was this? See the thread I started on false positives in Pylarify scans. Some of these were soft-tissue uptake. What is the workup plan? Can the lesion be biopsied?

Djin
Posted 7/22/2022 9:50 PM (GMT -5)
Hello, Newspaper ~

Sending supportive thoughts your way ...

I like the idea presented as to whether it can be biopsied.

When my initial diagnostic scans showed that both my luns were "peppered" with what looked like scattered "buckshot" throughout both lungs ~ a surgical biopsy followed.

The biopsy confirmed that the prostate cancer had spread into both lungs.

Treatments followed immediately on "diagnosis day" back in 2013 ~ but here I am today ...

Just thinking aloud ~ I wonder if any surgery is possible, followed by radiation?

Hopefully, you have a "trusted and true" medical team leading the way ~ rely on their expertise & remember that getting some answers, a plan, and a targeted treatment can bring a fellow some newfound H-O-P-E.

Djin Tonic has shared some keen & insightful thoughts.

I'll toss another thought into the ring ~ never hurts to seek out a second opinion.

Scans can be shared electronically, with ease & efficiency.

Just remember ~ where you are standing today is not where you have to remain standing in the weeks ahead.

Tie a knot into that survivor's rope and hang on!

My doctors have tossed me the proverbial lifeline, time and again.

Above all else ~ I am sending you my support and encouragement.

Keep us posted & let us know how you're faring ...

Handshake, from across the miles ~

CYCLONE ~ # Iowa State University
Posted 7/24/2022 12:26 PM (GMT -5)
Djin and Cyclone,

Thank you for your replies and ideas. I have always benefited from reading the thoughtful posts from both of you. Djin I read the Israeli study regarding false positives at very low levels of PSA using Pylarify. Unfortunately, my most recent PSA is 6.01, rising from a nadir of .16 last November. At that level it appears there is convergence between the F-18 and 68 Gal approaches. As it happens, my test was F-18. The report does note prominent physiological uptake in a few instances such as spleen, but then discounts these as “no abnormal uptake.” In the instance of the Soft Tissue finding, the radiologist did note that my nearby titanium hip limited anatomic delineation, but reported size at 1.1 cm with 75% probability of Soft Tissue disease to the right of the outside of the rectum wall. Lots of lymph line the outside of the rectum, but no finding of lymph in the report. Cyclone, my MO has discussed biopsy with me, and that will be on the table when I meet with my RO at MSK in August. I am inclined to think this is probably a very rare Soft Tissue met, and hope that radiotherapy may help. Best wishes and cooler weather for all… Bill
Posted 7/25/2022 9:57 AM (GMT -5)
Hello, Newspaper ~

Your upcoming appointment in August is timely, and the way the summer is zipping by, your consultation won't be far away.

Start jotting down your list of questions, keep forging ahead, and let your medical team lead you forward.

Are the new LUTETIUM-177 treatments a possibility? Just thinking aloud ...

We're here for you, and I am keeping you in my thoughts.

Keep us updated, and let us know how you're faring!

With my best ~
C-Y-C-L-O-N-E ~ # Iowa State University
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