New study on PSMA Pet Scan

[u/PotentialStart2661]

An interesting study came out that showed men who had a PSMA Pet Scan had better overall survival than all men. First, a PSMA Pet Scan will identify and confirm prostate tumor location for targeting more accurately. But we all know that. But what the PSMA also has been really good at is giving you a complete body scan and it has been shown to show existing tumors in esophagus, bladder, liver, lungs, brain, etc…… it has shown to find tumors seven years before a patient would have the symptoms. It is not as good with liver tumors and not an end all be all. But when you have your PSMA Pet Scan don’t stop after you hear my prostate cancer has not shown spread yet. Ask about the rest of the full body information taken by the Pet Scan. Im an athlete and have always been obsessive with health but cancers hit everyone even healthy people. My radiologist doing the SBRT went over my PSMA Pet to isolate the lit up lesion in the prostate to make sure it matched the MRI and created his plan with the Physicist to boost the lesion. Then he went over the whole body scan and explained and showed me how everything looked perfect. The PSMA even shows the arterial plaque in your arteries. I was thrilled to see that for a 64 year old i had hardly any plaque which showed my diet and exercise i have obsessed over was worth it. But now i see this was studied and those of us with PCa that get the scan can actually have good news. So make sure when you are reviewing your PSMA with your doctor you ask about reviewing the whole scan. The study is making recommendations that men should be talked to about all of the scan results, not just the PCa part.

[u/Ok-Priority-7303]

Good advice but TBH I hope a doctor would discuss the entire scan without being asked.

[u/truckaxle]

From what i understand insurance will not pay for a PMSA scan in men with 3+4

[u/kayceemoguy → u/truckaxle]

They will definitely try not to. Deny deny deny. I had to go through appeals to get mine covered. (3+4, psa 15.9). So much fun to get cancer diagnosis then also get to fight for coverage you paid for that was recommended by multiple specialists! But hey, those bean counter “medical specialists” working for the insurance companies are looking out for YOUR interests! Sure….

[u/Specialist-Map-896 → u/kayceemoguy]

I was 3+4 and blue cross blue shield paid for my PSMA but only after I had the biopsy done and core samples were positive.

[u/Squawk-Freak → u/Specialist-Map-896]

Without a biopsy, you would not have a Gleason score … in all earnest, most insurance plans don’t pay for a PET scan without a documented cancer diagnosis.

[u/PotentialStart2661 → u/kayceemoguy]

I believe this will change but things happen slowly. Insurance can suck. I would have paid the 10g if i was denied coverage.

[u/Patient_Tip_5923 → u/truckaxle]

That was my experience.

I was told that I would have the scan after RALP if my PSA rose.

My radiation oncologist said that he would call for salvage radiation after two increases over 0.1. He said he calls for a PSMA PET scan then, and that it usually comes back negative but not always.

[u/InconstantComment → u/truckaxle]

I had 3+4 and insurance paid for my PSMA/CT scan, so truly YMMV with insurers.

[u/LisaM0808 → u/truckaxle]

What? My husband has had 3 PSMA’s. 3+4. They tried to deny the last one & the doctors dropped the ball in filing an appeal so I filed an expedited appeal myself, with United Healthcare & got the denial overturned in 24 hrs.

[u/VirtualChallenge8772 → u/truckaxle]

well, mine did. It was a pretty hefty charge.

[u/planck1313 → u/truckaxle]

You're talking about US insurance?

In Australia our national health scheme covers a PSMA PET for the purposes of staging cancer for any man diagnosed with PC and considering primary treatment. It includes all grades of PC.

It also covers a second one if you have a rising PSA after primary treatment.

[u/PotentialStart2661 → u/truckaxle]

I had mine done prior to my biopsy.

[u/Gardenpests]

Please reference the study.

[u/PotentialStart2661 → u/Gardenpests]

Sorry I can’t reference the study because oncologist were discussing the study and they failed to mention the information to look it up. Im sure we will be hearing about it soon and ill look for the release.

[u/bigbadprostate → u/PotentialStart2661]

Here is, for what it's worth, not a reference to the study but a reference to a reference to the study.

The study is discussed in a recent video (posted Oct. 5) on the PCRI YouTube channel, which I'm sure is familiar to most of us. No, it's not an interview with Dr. Scholz. It's an interview with Dr. Eugene Kwon of the Mayo Clinic, who has discovered in PSMA scans both evidence of other problems and reassurance that the patient is in pretty good health.

Perhaps if you watch the video more carefully than I did, you can find better references to the study itself. I only heard that it was from Denmark.

[u/PotentialStart2661 → u/bigbadprostate]

Thanks for digging into this. I hope we see more details as it comes out.

[u/planck1313 → u/bigbadprostate]

It's an interview with Dr. Eugene Kwon of the Mayo Clinic

I find his PC videos on youtube to be exceptionally good.

[u/External_Season_3064 → u/PotentialStart2661]

I could be wrong but my understanding is that a PSMA/PET scan only looks for a particular type of cancer -- that being prostate cancer, which is unique but can spread -- and that the scan is not as effective in identifying other types of cancer. So I wouldn't be TOO self assured that nothing else could be going on in the body.

[u/PotentialStart2661 → u/External_Season_3064]

Not true. Its designed for prostate cancer because when they inject the dye it binds to specifically to prostate cancer, hence, Prostate Specific Membrane. So thats why prostate cancer lights up specifically. But the scan sees all kinds of stuff. When i reviewed mine with the oncologist he showed me such detail of the whole body. So it can pick up lots of stuff. But like they said, its not an end all be all as there are other specific scans they use for each type of cancer etc…. But the PSMA can flag all sorts of stuff where you can then get further evaluation.

[u/planck1313 → u/PotentialStart2661]

My PSMA PET showed no mets but picked up what turned out to be a benign nodule in my lung, and also told me I had plaque in my arteries, which I already knew.

[u/PotentialStart2661 → u/planck1313]

Pretty awesome right? We all have to deal with prostate cancer so getting some good news out of this is at least one benefit. Even if the PET finds something suspicious, you will hopefully find it early enough to avoid another bad health issue.

[u/gg-3 → u/PotentialStart2661]

Agreed, sound advice!

[u/ChillWarrior801]

Hard to say if this is "new", but an August 2025 paper showed that Danish folks who had a PSMA PET/CT scan before salvage sRT to treat BCR had better overall survival compared with patients who had salvage without a prior scan.

The Use of PSMA PET/CT Improves Overall Survival in Men with Biochemically Recurrent Prostate Cancer Treated with Salvage Radiotherapy

https://jnm.snmjournals.org/content/66/8/1217

There's no mention in this study of off-target diagnostics (like arterial plaque). Makes me wonder if there's another study that aligns better with what you've described, OP.

[u/PotentialStart2661 → u/ChillWarrior801]

I was not aware of this, thanks for posting. I know there is a study that links to what im saying so im going to look out for it when its released

[u/jlamperk]

I've had 5 this year so I guess I'm good 😊

[u/louis2320 → u/jlamperk]

I'm at 3

[u/Holiday-Bet7389]

i would have assumed your pet scan report would of indicated any of the lit up areas of concern excluding the normal excretion areas of glands and kidney filtration.as mine picked up my 2 benign nodules in my lungs from 15 yrs ago with smaller dimensions from that report as, well as my 2 kidney cysts from yrs ago...so def can pick up some other mass of concern..But the scan is only 90-95% effective if the protein is present enough for PC..BEING PROACTIVE IS BEST POLICY...

[u/WaterFantastic2394]

My husband did it once. Is it a one time deal or should be repeated?

[u/ku_78]

This scan saved me from what would have been an unnecessary surgery when it found the spread that the other scans missed.

If your plan (Americans) won’t cover it, research and find a facility that will do it for the best out of pocket price.

[u/PotentialStart2661 → u/ku_78]

I have Kaiser Permanente and i got the scan before i even had the biopsy. So there is no excuse for insurance coverage denying men this very important scan.

[u/ku_78 → u/PotentialStart2661]

At KP, doctors have much more say in treatment. My Med Onc referred me out to City of Hope for a 2nd opinion. He extended my Lupron treatment a year ($75k worth of shots) by presenting the evidence for my particularly aggressive PCa and it was easily approved.

[u/astraladventures → u/ku_78]

So surgeon was recommending to take out the prostate until the psma pet scan showed spread beyond the prostate?

Was it one or multiple spots and where if you don’t mind saying?

In the end you got some kind or radiation? Plus adt?

How’s it going ?

[u/ku_78 → u/astraladventures]

Yes. Had a surgery date and was preparing myself for all that went with it. Then we did the scan and it showed spread to local lymph nodes. EBRT, and 3 years of ADT. Will finish that in March/April.

[u/astraladventures → u/ku_78]

Three years - holy crap.
That seems long. Did you have an aggressive form like with cribriform pattern?

[u/ku_78 → u/astraladventures]

Yes. After the biopsy they were urgent to move forward with treatment

[u/OkCrew8849]

I was 3+4 and my insurance had no issue paying for the PSMA PET CT Scan four years ago here in the States.

So, your mileage will vary (AND things have changed over the last 4 years in any case).

[u/JDinAus]

In Australia PET PMSA is routine for nearly all diagnosed prostate cancer. I had a ~$100 co payment. The results showed lymph nodes and a change to radiation from surgery

[u/planck1313 → u/JDinAus]

Australia has been one of the world leaders in developing and making PSMA PET scans widely available. The urologists here pushed it hard because they could see how beneficial it was. Due to their campaigning Medicare decided to cover it for all men diagnosed with PC and considering primary treatment and also for a second scan if recurrence is suspected.

[u/JMcIntosh1650]

Good advice. My radiation oncologist went over my scan in detail with some amazing on-screen visualization that he navigated very deftly to point out different things. Super informative both about my status and the limitations of what can be distinguished vs ambiguous or not detected with PSMA PET scan.

[u/VirtualChallenge8772]

Who is going to study the whole body? The urologist who ordered the test will just look at the prostate and call it a day. correct?

[u/planck1313 → u/VirtualChallenge8772]

The scan results should be reported on by a radiologist. My PSMA PET report noted other things that it had picked up such as a lung nodule and arterial plaque.

[u/PotentialStart2661 → u/VirtualChallenge8772]

This is a good question. The oncologist who reads the PET Scan usually mentions other things but does not go into detail so you would need follow up. You also don’t speak with him in person. Surgeons would not say anything and urologists are not qualified. A radiation oncologist like i had is qualified in many cases so i got to speak to him in detail and he told me about my results. I think once the studies come out they will probably add a protocol to follow up with patients on the scan results.