Results after prostate cancer surgery can vary: in some men the cancer never comes back, while in others it does. Doctors attempt to estimate the percentages of reoccurrence by reviewing certain forms of medical information. For example, if a person's biopsy results show a really aggressive cancer, then reoccurrence is more likely. A really high or rapidly rising prostate-specific antigen (PSA) level before surgery can also be related to a worse end result.
Researchers are working hard to develop even higher tools to discover which men might profit from additional therapy or closer monitoring. Genetic tests are helping with these risk stratifications, and so are latest forms of medical imaging.
In December, Stanford University scientists reported Promising results With a brand new technology that illuminates prostate tumors on special imaging scans. The approach relies on a minimally radioactive tracer that travels through the body on the lookout for cancer cells. Called 68Ga-PSMA-11, and delivered intravenously, the tracer binds specifically to a protein called prostate-specific membrane antigen (PSMA). Prostate cancer cells have more of this protein on their surfaces than normal prostate cells. Flagged by Tumor 68Ga-PSMA-11 appears on an imaging scan like a lighted match in a dark room. Doctors are already using PSMA scans to diagnose early metastatic cancers, and the tracer can be used to deliver drugs directly into malignant tumors.
Research methodology and findings
For this study, the Stanford team desired to know if the scanning technology would predict the reoccurrence of prostate cancer after initial treatment. The researchers enrolled 73 men with intermediate or high-risk features on tumor biopsies, and gave them a dose of every. 68Ga-PSMA-11. They then measured how much of the tracer was taken up by the prostate, in addition to any bits of cancer that were possibly spreading throughout the body. After that, the lads had their prostates removed.
Cancer reoccurrence was assessed by evaluating changes in PSA levels. If a person has had his prostate removed, the extent should drop to zero, so a persistent elevation or sudden rise in PSA after surgery indicates that cancer remains to be within the body. This form of reoccurrence is known as biochemical failure.
The men were pursued for nearly three years. According to the ultimate results, men with lower tracer uptake values ​​before surgery performed higher over time than men with higher uptake values. Men with low tracer uptake values ​​avoided biochemical failure for at the least two years after their operation. In contrast, men with the very best tracer uptake values ​​before surgery and/or PSMA-detected metastases were more prone to have biochemical failure in the course of the study period.
Expert opinion
“We found that the information we could get from PSMA scanning in patients with newly diagnosed prostate cancer before surgery was at least as reliable and useful as biopsy, PSA levels, or a clinical exam to predict how patients will do after surgery,” says Farshad Moradi, a Stanford radiologist who co-authored the study. “Information from a PSMA scan can help patients and their doctors make more informed and better decisions about treatment options and follow-up, which we hope will improve long-term outcomes as well.”