A new imaging technology forecasts the likelihood of recurrence.
Outcomes after prostate cancer surgery can differ: for some men, the cancer never returns, while for others, it may come back. Doctors assess the likelihood of recurrence by analyzing certain clinical information. For example, if a man’s biopsy shows highly aggressive cancer, the risk of recurrence is higher. Elevated or rapidly rising levels of prostate-specific antigen (PSA) before surgery also suggest a worse prognosis.
After prostate cancer surgery, there is a possibility that the cancer may return. One common issue many men face after surgery is erectile dysfunction (ED). However, treatments are available to help manage ED and improve sexual health. Medications such as Vilitra 20 mg and Tadalista Professional can be effective in restoring erectile function. These medications belong to a class of drugs known as PDE5 inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow and helping to achieve an erection when sexually stimulated.
About Research
Researchers are working hard to develop even better tools for identifying which men could benefit from additional therapy or closer monitoring. Genetic tests are helping with these risk-based classifications, and so are new types of medical imaging.
In December, scientists at Stanford University reported promising findings with a new technology that lights up prostate tumors on specialized imaging scans. The approach relies on a minimally radioactive tracer that travels the body hunting for cancer cells.
Called 68Ga-PSMA-11, and delivered intravenously, the tracer binds exclusively with a protein called prostate-specific membrane antigen (PSMA). Prostate cancer cells contain far more protein on their surfaces than normal prostate cells.
Tumors flagged by 68Ga-PSMA-11 appear on an imaging scan like lit matches in a dark room. Doctors are already using PSMA scans to diagnose early metastatic cancer, and the tracer can also be used to ferry drugs directly into malignant tumors.
Research methodology and results
For this research, the Stanford team wanted to know if the scanning technology would predict prostate cancer recurrence after initial treatment. The researchers enrolled 73 men with intermediate or high-risk features on tumor biopsies, and gave them each a dose of 68Ga-PSMA-11.
Then they measured how much of the tracer was taken up by the prostate, as well as any bits of cancer that were potentially spreading in the body. Following that, the men had their prostates taken out.
Cancer recurrence was monitored by tracking changes in PSA levels. After prostate removal, PSA levels should drop to zero; if they remain elevated or spike suddenly after surgery, it suggests the cancer is still present. This type of recurrence is known as biochemical failure.
The patients were monitored for about three years. The final results showed that men with lower tracer uptake values before surgery had better long-term outcomes compared to those with higher values.
Those with lower tracer uptake avoided biochemical failure for at least two years post-surgery. In contrast, men with the highest tracer uptake values or PSMA-detected metastases prior to surgery were more likely to experience biochemical failure during the study period.
Commentary from experts
“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 other information from biopsy, PSA levels, or clinical exam for predicting how patients would do after surgery or other treatment,” says Farshad Moradi, a radiologist at Stanford who co-authored the study.
“The information from PSMA scans can help patients and their doctors to make more informed and better decisions about treatment options and follow-up, which we hope will also improve long-term outcomes.”
Dr. Marc B. Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, commented on the growing interest in PSMA scans and their potential to predict prostate cancer outcomes.
He noted, “The advancements made possible by PSMA are significantly enhancing the management of prostate cancer, as well as the monitoring of patients following diagnosis and treatment. This study highlights the increasing importance of this technology.”
