While not all men with prostate cancer die of the cause, it remains one of the leading forms of fatal cancers among men. After recurrence, treatment and survival depend largely on early detection.
Patients with prostate cancer have significantly improved progression-free survival because of modern treatment strategies. Yet, early detection of recurrent disease continues to pose challenges after such treatments as prostatectomy or radiotherapy.
Until recently, it has not been possible to observe early metastatic spread to lymph nodes and bone. PSMA PET/CT scans are a relatively new diagnostic technology that assists in locating and determining the extent of prostate cancer. With PSMA scans, therapy can be targeted more directly as it can assess the area of the prostate, as well as lymph glands and bones.
How it Works
Found in aggressive tumours, metastatic and hormone-refractory carcinomas, PSMA is a cell surface target that this expressed by nearly all prostate cancers. Given the high PSMA uptake in prostate cancer cells, it provides a biological target for PET imaging particularly in spotting small lymph node, bone and liver metastases. The goal of PSMA PET scans is to identify and determine prostate cancer recurrence in patients with elevated serum and no other symptoms after definitive therapy.
Effectiveness
To date, PSMA PET scans for cancer are much accurate than other scanning methods, including the Choline PET/CT scan. Nevertheless, positive PSMA PET scans prove to be false positives in less than 2% of patients given the very sensitive imaging technology.
Overall, PSMA PET scans have still been a major development in early detection of secondary prostate cancer, and provide promising advances for future patients.
Dr Peter Swindle is a Brisbane-based urologist who specialises in the diagnosis and treatment of prostate cancer. For more information on his services, call (07) 3010 3333.
