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Published in Advanced Prostate Cancer

Expert Opinion / Cases · February 14, 2018

PSA Recurrence After EBRT + ADT

Written by
Jeffrey J. Tosoian MD, MPH

 

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Jeffrey Tosoian MD, MPH

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  • Sara  Alatriste

    Feb 16, 2018

    I think is neccesary PET

  • William Dieterich

    Feb 16, 2018

    Seems like any of the new tracers (C11,F18,Gal68) would be one of the next steps. Gal68 is not
yet approved for PC imaging, but available at USC, USSF and maybe other places in the states. This looks like a serious situation with PSA doubling in a short amount of time. Treatment options would be more clear once advanced imaging reveals where the problems are. I'm not a doc, but I'd be looking at getting into the Mayo clinic, MD Anderson, UCAF, Sloan Kettering etc. cancer center soon for a consult.

  • Georg Potthast

    Feb 16, 2018

    I recommend a PSMA PET/CT or PSMA PET/MRI

  • Pyara Chauhan

    Feb 17, 2018

    This is a young patient with aggressive CaP treated with EBRT and ADT and presents with significant rise in PSA. Regardless of the metastatic work up results further treatment is indicated. As a first step I would recommend Abiraterone and Prednisone.

  • STUART SHOENGOLD

    Feb 17, 2018

    Axumin scan

  • Klaudiusz Malachowski

    Feb 20, 2018

    I suggest KT of the abdominal cavity - assessment of aortic lymph nodes.
In case of (-) observations
Next tests:
MRI of the small pelvis + bone scintigraphy after doubling of the PSA.

  • Theresa Laurent

    Feb 25, 2018

    Radiological investigations can include PET/CT or PET/ Choline to determine disease burden, but definitely requires  treatment with Arbiraterone and prednisolone

  • Tom Schneider

    Nov 11, 2019

    PSMA PET/CT or PSMA PET/MRI recommended: yes
In case of oligometastasis : regional therapy e.g. stereotactic ablative radiotherapy can be used
in case of more metastatic burden a stronger systemic line has to be used.
Both can be combined

  • Apr 20, 2024

    Pending Moderator approval.
    Delete

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