October 12, 2016
HACKENSACK, N.J.(CBSNewYork) – There is a new kind of scan to tell if prostate cancer has spread or returned.
And as CBS2’s Dr. Max Gomez explained, it can detect cancer at its earliest stages.
Ernesto Shore had been following his doctors orders and getting regular PSA blood tests to check for prostate cancer. When his numbers went up earlier this year the news was not good.
“And they found an uh, an advanced case of prostate cancer, which, good chance that it spread beyond my prostate,” he said.
Ernesto had surgery to remove his prostate so his PSA number should have dropped to zero, or very close to zero. Instead it was going up. His cancer had spread or recurred, but where?
“So we can do an MRI, we can do a bone scan, but until that tumor gets big enough that we can actually see it, we don’t know where it is,” Dr. Michael Stifelman, Hackensack University Medical Center said.
That’s where a new kind of PET scan comes in. It uses a radioactive tracer called C-11 that is taken up by prostate cancer cells.
Dr. David Panush gave CBS2’s Gomez a look at the PET scan. There were lots of normal hot spots, but a closer look shows a hot spot in a lymph node.
“We can detect disease before a bone scan becomes abnormal, and before a CT scan shows enlarged lymph nodes. Thereby able to treat patients earlier, if indeed their tumor has come back,” Dr. Panush said.
By finding very early cancer recurrence, doctors can decide the best treatment to deal with the disease.
“If it’s in a local area, we can do radiation, we can sometimes even do surgery. Whereas if it’s more distant, it’s like, in the bone, we know those techniques won’t work and we go right to hormonal ablation,” Dr. Michael Stifelman explained.
Ernesto was thankful that his recurrence was found early.
“If uh, had a regular PET scan, it might not have showed this, and I would have thought, ‘okay, maybe just PSA’s wrong. I’ll do some more tests, and wait, and wait, and wait.’ And of course if you wait, boom, the cancer really grows, and it could become pretty dangerous,” he said.
The C-11 test is too expensive and complicated to use as a screening test, and because the C-11 degrades very quickly a hospital has to have a cyclotron on site to make it.
For men who’ve had prostate cancer – and are at high risk for recurrence – the test could be a lifesaver.