Can a CT scan detect prostate cancer if PSA is only .34

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Can a CT scan detect prostate cancer if PSA is only .34

by vonnegute on Sun Dec 16, 2018 09:43 PM

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After a RP and then two and a half years later (after rising PSA) salvage radiation, my husband's PSA has gone from .07 to .34 in 5 months. We wanted to do an Axumin pet scan but our insurance made us do a regular CT scan first. Much to our surprise a "new 13 mm ovoid soft tissue mass in the lateral right hemipelvis just superior to the acetabulum. This likely reflects a lymph node. No other new potential lymphadenopathy is identified."  

Then "CLINICAL INDICATION:
Diagnoses: Malignant neoplasm of prostate" 

The doctor recommends hormone therapy, and since we were planning on traveling overseas this winter, ordered a six month hormone shot.

My concerns...

1) How can prostate cancer show up on a CT scan if PSA was only .34? None of us were expecting a positive result with such a microscopic psa level.

2) Could the tumor on his lymph node be a different kind of cancer? Does a "new 13 mm ovoid soft tissue mass" translate to cancerous tumor? Should we remove it and do a biopsy?

3 ) Should we consider doing targeted radiation therapy on the lymph node? If so, we could return to the United States in the 2nd half of January to start that.

Please reply asap since he is scheduled to get the hormone shot this Monday.

RE: Can a CT scan detect prostate cancer if PSA is only .34

by genemyers on Mon Dec 17, 2018 04:12 AM

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A CT scan usually do not show anything until the psa is 20-50. That is because the CT scan is insensitive and just looks at the size of the lymph node. I am not to good about reading this but it sounds like a mass in a lymph node.

My concern is that you base various treatment decisions on just one CT scan. You could wait and do the Axumim or gallium-68 scan to try to confirm what the CT is saying. The whole insurance thing is just bizzare.

You could also call the radiologist and ask them to explain the report to you and answer your questions. You could wait until Jan and get another psa test.

On the other hand if waiting or getting more scans is not going to change getting a Lupron shot, then unless you are considering other therapy, based on the psa rise alone, you might just get the shot. 

Kind of hard to know what to do without taking more time to investigate and call around and get more information.

 

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