How to understand PSMA report

Andy,
The more doctors you see the bigger the mess seems to get.

No one knows if this nodule is of any consequence. The radiologist was unwilling to even give a cancer alert. He just didn't rule it out

Will the radiation negatively affect the aortic arch?

It seems questionable that the CT scan will yield new information, but I guess it wouldn't hurt.

I suppose if the nodule is a PCa met, you *might* see your PSA go down after treatment. That would be useful information, and might imply going on ADT sooner than waiting too long. (Seeing mets on a scan has been a criteria for initiating ADT).

I'm starting to fall into agreement with Mumbo for waiting some time interval then doing a comparative scan to look for any changes in the nodule.

It just seems, to me at least, the probability is low for a PCa met or even lung cancer. But it could be. None of us are doctors and I wouldn't trust our opinions.

Before subjecting yourself to possibly harmful treatments, I encourage to find a doctor's opinion you trust.

Andy - I think all of us who had surgery + RT wonder what the future will bring and how we will deal with it if and when it happens. I know I keep up on prostate things just for that reason alone and keep hoping that better ways of locating and treating PCa metastasis are developed than what flavor of ADT would I like for the rest of my life. Your situation is of much interest to me as the PSMA scans are a game changer but have their share of limitations as well as experience with them is being gained (some PCa does not yield PSMA).

Your proposed treatment has the potential to yield positive results or worst case, negative results with treatment side effects and increasing PSA. That is a tough situation that only you can decide for yourself.

All I can say, not being in your shoes, is that more time with a rising PSA may allow a PSMA scan to yield a more conclusive result and/or give the nodule time to grow enough that the CT scan may be able discern a difference in size from previous scan if not benign. Seems you need just a little bit more information to make this decision easier. It is possible that your proposed diagnostic CT may provide the information you need but your PSMA/CT was just a little over a week ago so I would not expect measurable difference in lesion size. Do you have any chest CT's over the last 10 years by chance? Are you seeing a Medical oncologist about your situation?

I am not a doctor so my thoughts are just the ramblings of man based on his own PCa adventure.

Its a weird position to be in, HOPING the lung mets are pca.

I think the most important thing is you do something, and you are comfortable with that something.

So you are on track. They will confirm with a CT, get a coordinate, and blast it. If it is lung cancer you have preemptively took a mighty swing.

If its PCa chances are there will be other mets, but you never know!

Good luck andyatil.