An important tool helping health care providers assess prostate cancer spread has significantly improved imaging techniques helping locate prostate cancer lesions. PSMA PET-CT and the PET imaging drug Gallium, approved by the FDA back in December 2020, accurately detect prostate cancer spread as has been found in studies.
“Most men diagnosed with prostate cancer usually have their cancer confined to the prostate gland. But then there are men who have a higher risk of their cancer eventually spreading beyond the prostate gland,” said Dr. David Samadi, Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Roslyn, New York and author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness. “This new technology is an important game-changer for high-risk patients helping find possible metastases of their prostate cancer and exactly where they’re located.”
What is PSMA PET-CT?
PSMA stands for prostate-specific membrane antigen which is a protein found primarily on prostate cancer cells. PET stands for positron emission tomography, a nuclear imaging test that uses a special dye with radioactive tracers scanning for cancer. PET-CT scans combine a CT scan with a PET scan that uses intravenous injections of a radioactive ‘tracer’ that can be detected on a scan.
“For years, the main way of finding metastatic prostate cancer has been with a conventional CT scan, MRI, and even bone scans since prostate cancer can spread to the bones,” explained Dr. Samadi. “These imaging technologies have limitations though, such as missing very small tumors. That’s why the PSMA PET-CT scan technology is exciting news as it can identify cancer that is often missed by current standard-of-care imaging techniques.”
In a PSMA PET-CT, it uses a PET-sensitive radioactive imaging agent or tracer drug called Gallium (Ga) or Ga 68-PSMA-11. This agent is injected into the patient and then attaches itself like a lock and key to PSMA proteins often found in large amounts on prostate cancer cells. The cancer cells then “light up” on the PET scan finding the location within the body where the PSMA tracer is concentrated, indicating where the tumors have metastasized to.
More recently, a second PSMA-targeted PET imaging drug called Pylarify (piflufolastat F 18), was FDA approved and is indicated for men with suspected prostate cancer metastasis and who are potentially curable by surgery or other therapy. Pylarify is also indicated for patients with suspected prostate cancer recurrence based on elevated PSA levels.
Dr. Samadi added, “I’m impressed with what I’ve seen. It’s a much more precise way of detecting prostate cancer not only in the prostate gland but also throughout the pelvis and body where prostate cells have migrated to. This results in better methods of treating and targeting the right method of care for these men.”
Is the use of PSMA PET-CT right for every prostate cancer patient?
Currently, FDA approval of PSMA PET-CT is for two groups of patients with prostate cancer.
“These men include those who are initially diagnosed with prostate cancer with a risk for metastatic disease and also for men previously already treated for localized prostate cancer but who have a rising PSA which could indicate a tumor that has spread beyond the prostate,” explained Dr. Samadi. “Keep in mind that most cancers grow as obvious masses or tumors to these changes are easy to see. But prostate cancer is different. Prostate cancer cells often replace healthy prostate tissue so changes are not as obvious making a PSMA PET-CT a valuable diagnostic tool.”
Prostate cancer will be the most commonly diagnosed cancer in American men in 2021 with close to 250,000 new cases estimated, making this type of technology even more critical in finding metastasized prostate cancer cells saving more men’s lives.
“I would encourage men who qualify for the use of a PSMA PET-CT to thoroughly discuss this with their doctor,” advises Dr. Samadi. “Ask their opinion and where this diagnostic tool is available. I’m hoping to see access for men to this lifesaving technology throughout the world as a goal in the fight against prostate cancer.”
The Ultimate MANual, Dr. Samadi’s book, is now available online both at Amazon and Barnes & Noble. Follow Dr. Samadi on Twitter (@drdavidsamadi), Facebook, and Instagram (@drdavidsamadi).
Anyone wishing to learn more about Dr. David Samadi’s book, Prostate Cancer or any Men’s Health topics for interviews or other media appearances can contact him here: