The PSMA PET Scan Test for Metastisis
My Prostate Cancer Diagnosis – Episode four.
Not surprisingly, I wanted to get the PSMA PET scan done as soon as possible. The earliest available appointment was at a new hospital close to where I used to live. I scheduled it immediately.
Walking Into the Cancer Facility
Walking into the waiting room of a cancer facility is never pleasant. The air is thick with worry. Many of the people sitting there are sick, or at the very least, waiting for news that could change their lives. While I was waiting, a woman I knew from a few years ago came over to say hello. She had been successfully treated for breast cancer and was there for a check-up.
“Mine’s the prostate,” I said quietly. Then I looked away, feeling an unexpected sense of shame.
Did My Body Betray Me?
Why was I ashamed? Because I knew what people would think:
See? All that fitness and plant-based diet stuff—it makes no difference.
Except it does. But at that moment, it felt like a betrayal. My body had let me down. I’d done everything right, and yet, here I was.
This had to be bad luck or genetic—I hadn’t had those tests yet.
What Is a PSMA PET Scan?
A nurse ushered me into a small room where she explained the first step.
For a PSMA PET scan, they inject you with a radioactive tracer—a special dye that allows cancerous cells to light up on the scan. For prostate cancer, the most common tracers are Gallium-68 PSMA or Fluoride-18 PSMA. These compounds attach to prostate-specific membrane antigen (PSMA) found in prostate cancer cells, making them visible.
Once injected, you have to wait about 45 minutes for the tracer to circulate throughout your body.
A Staggering Number
While I was waiting, I got into a conversation with the nurse. One thing you quickly learn in cancer centers is that many of the staff have personal connections to cancer—either they’ve had it themselves or someone close to them has.
The nurse told me about a patient who had come in with a PSA over 2,000—a staggering number.
“We couldn’t believe it,” she said.
By contrast, my PSA was low, meaning the likelihood of the cancer having spread was lower. But uncertainty eats at you. Being naturally anxious and a bit of a hypochondriac, I was freaking out.
“Would you be able to see something on the scan?” I asked. “Would you know?”
She hesitated, then smiled politely.
“We can’t tell you anything… but of course, we see things.”
That told me everything I needed to know. They might not be able to tell me, but they would know.
The PET Scan Experience
When it was time for the scan, I was led into a cold room with a massive PET-MRI machine. I lay down on the table, and the nurse positioned me carefully.
Why a Full Bladder Matters
For PET scans of the prostate, it’s better to have a reasonably full bladder to improve image clarity.
So, of course, with the anxiety and stress of the test combined with waiting 45 minutes for the dye to circulate, I was concerned I’d need to pee in the middle of the MRI.
All this just made me more focused on my bladder.
The Noise and the Wait
Then came the noise.
If you’ve never had an MRI, imagine the sound of bricks tumbling around in a metal drum—loud, rhythmic, and relentless. The machine moved me in and out several times, scanning different sections of my body. I could feel vibrations, and occasionally, everything went still before the deep hum resumed.
One unexpected touch? Music. They let me choose what I wanted to listen to—a small kindness in an otherwise clinical experience.
I just wanted it to be done so I could go pee.
What the Nurse’s Expression Told Me
The scan itself took about 15–20 minutes. After I came out, the nurse was leaning against the doorframe, looking, in my observation, a little glum.
Maybe she was just tired—it was late in the afternoon—or had her own things on her mind.
But in my mind, this was clearly an indication it was going to be bad news.
I looked at her expectantly, wanting to ask if she’d seen anything. She must have noticed my unease because she smiled and said:
“Don’t worry, it’ll be fine.”
Now, all I could do was wait.
More About PSMA PET Scans & PSA Levels
If you or a loved one is facing a PSMA PET scan, here are some useful resources:
- What is a PSMA PET Scan? – A breakdown of how it works and why it’s used for prostate cancer.
- How High Can PSA Go? – Some extreme PSA cases are in the thousands.
- What PSA Level Suggests Metastasis? – Typically, a PSA over 20 raises concerns, but metastases have been found at much lower levels.
