The Food and Drug Administration has approved a new imaging agent to detect prostate cancer after it has spread to other parts of the body.
Experts say the tracer, made by medical imaging company Lantheus, will provide doctors with an important visual aid in guiding them to metastatic prostate cancer cells that were previously difficult to spot.
Prostate cancer is the second leading cause of cancer death in men in the United States, after lung cancer, according to the American Cancer Society. More than 34,000 men die from the disease each year.
When prostate cancer spreads, it often enters the bones, said Dr. Michael Morris, medical oncologist at Memorial Sloan Kettering Cancer Center in New York City. This makes detection difficult using traditional imaging techniques.
“It’s really hard to take pictures of what’s going on inside the bone,” Morris said, adding that traditional scans tend to find problems in the tissues surrounding the bones after the damage. have already been made.
“Now we don’t have to wait for this,” said Morris, who participated in the clinical trials of the tracer. “We can detect it much more clearly and much earlier than before. “
The new technique uses a tracer molecule that searches for a protein found on most prostate cancer cells called prostate-specific membrane antigen, or PSMA. The tracer, which is injected into the bloodstream, illuminates these cells during a PET scan.
A similar tracing agent, which also tests for PSMA, was approved by the FDA in December for use in two California hospitals: the University of California at Los Angeles and the University of California at San Francisco. Facilities have been looking for this type of technology since 2015.
“We’ve been using it for many years and it’s working really well,” said Dr. Thomas Hope, director of molecular therapy in the Department of Radiology and Biomedical Imaging at UCSF. “We can actually see where the disease is and now people are getting targeted radiation. “
“It’s redefining the way we think about prostate cancer,” he said.
The new approval will be the first tracer of its kind for advanced prostate cancer commercially available nationally.
The test is not intended to replace the PSA test, a common tool for screening for prostate cancer. PSA stands for prostate specific antigen, a protein found in the blood. Instead, it is intended for men who have already been diagnosed with illness.
The scan would be more useful for prostate cancer patients who have rising PSA levels after undergoing treatment, including surgery and radiation therapy, said Dr Xiao Wei, an oncologist at Dana- Farber Cancer Institute of Boston. A rising PSA level would indicate that the cancer has spread elsewhere in the body.
Although Wei and other prostate cancer experts agreed that imaging would give them more information about metastatic cancer, it’s still unclear what they should do with that information.
“The big question is, does this really have an impact on what we do for the patient? Will it help us improve results? Said Dr. Justin Gregg, assistant professor of urology and health disparities research at the MD Anderson Cancer Center in Houston.
Treatment for prostate cancer is often personalized, depending on a man’s age, any other risk factors he may have, or how aggressive the cells are under the microscope. Treatment, which can include radiation therapy and prostate removal, can have serious side effects, including impotence and incontinence.
And not all metastatic prostate cancer threatens a man’s life.
“We can find deposits, but in a 75- or 85-year-old man, they can sit there and not need urgent treatment,” said Dr. Derek Raghavan, president of the Levine Cancer Institute in Charlotte, Carolina. North. “There is also a variant of prostate cancer which can be metastatic and not harm the patient for several years. “
The new imaging is unable to determine which types of prostate cancer cells are likely to be more dangerous, Raghavan said.
“I guess as they develop the technology,” he said, “they will develop a refined method to identify those who have the potential for rapid growth”.
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