BAFANGUY
I wish your friend well. It’s a worrying time for sure so hope he is treated well. Re the PSA test my understanding is that it can be unreliable in both senses. A high score doesn’t necessarily mean one has prostate cancer and a low score does not guarantee that cancer is not present. This is, I believe, a fundamental problem with the test in that it does not directly detect for cancer but provides an indication that may be useful in determining if further tests are required such as MRI, template biopsy etc. For what it’s worth my own Aviation physician thinks PSA tests should be given to every man over 50 and younger if there is a family history.
The PSMA PET scan you asked about involves an injection of a radioactive isotope that will, if present, attach itself to any prostrate cells present. For a patient that has had a radical prostatectomy there shouldn’t be any cells because the prostate is now in a jar in some hospital having been sliced and diced to analyse the extent of the cancer within it! I believe ten percent is a typical value. What the scan provides is a cross sectional image where prostrate cells appear a different coiour to the surrounding tissue. Hence the PET scan is a useful tool in aiding detection but is not part of the treatment as such.
Anyway, happy to be corrected by Radgirl or anyone suitably qualified. This isn’t a clear cut issue - no pun intended!