“The American Cancer Society estimated that 220,800 new cases of prostate cancer will be diagnosed in the United States in 2015. Approximately 27,540 men will die of the disease, accounting for 5 percent of all cancer deaths.
“A common treatment for prostate cancer is a prostatectomy, in which all or part of the prostate gland is removed. Recent studies have shown that this procedure is often over-prescribed. As early as 2010, the New England Journal of Medicine reported that such a procedure extended the lives of just 1 patient in 48. Side effects from the surgery, including urinary incontinence and impotence, can affect the quality of life of the patient.
” ‘For every 20 surgery procedures to take out the prostate, it is estimated that only one life is saved,’ said Gabriel Popescu, director of the Quantitative Light Imaging Laboratory (QLI) and senior author on the study. ‘For the other 19 people, they would be better left alone, because with removing the prostate, the quality of life goes down dramatically. So if you had a tool that could tell which patient will actually be more likely to have a bad outcome, then you could more aggressively treat that case.’ ”
“A recent study reported in The Journal of Nuclear Medicine compared use of the novel Ga-68-PSMA-ligand PET/CT with other imaging methods and found that it had substantially higher detection rates of prostate-specific membrane antigen (PSMA) in patients with biochemical recurrence after radical prostatectomy. Discovering a recurrence early can strongly influence further clinical management, so it is especially noteworthy that this hybrid PSMA-ligand identified a large number of positive findings in the clinically important range of low PSA-values (<0.5ng/mL).
“According to the CDC, prostate cancer is the most common cancer among men in the United States, after non-melanoma skin cancer. While many men with prostate cancer die from other causes, prostate cancer remains one of the leading causes of cancer death among men of all races. Treatment and survival after recurrence depend on many factors, but early detection of the recurrence is certainly key.
“Matthias Eiber, MD, corresponding author of the study, noted, ‘The study is the first to examine this highly promising PET tracer in the use of a homogeneous patient collective consisting of only those with biochemical recurrence after radical prostatectomy. It found superb detection rates compared to other tracers, like choline, or imaging modalities, like MRI. For patients, this means that the referring urologist can receive earlier and more precise information about the site and extent of metastatic disease. Physicians will also be better able estimate whether a PSMA-PET scan might be useful in a specific setting.’ “
Editor’s note: People who have been treated for breast cancer may experience a recurrence; that is, their cancer may come back. Scientists recently tested and compared different ways to detect recurrence. Out of 1,000 women, the scientists found, about 18 will have recurrent cancer that is missed by mammography and ultrasonography, but is successfully detected with MRI. The results suggest that women who have undergone breast conservation therapy might do well to be screened for recurrence using MRI.
“Single-screening breast magnetic resonance imaging (MRI) detects 18.1 additional cancers after negative findings with mammography and ultrasonography (US) per 1,000 women with a history of breast cancer, according to a study published in the August issue of Radiology.
“Hye Mi Gweon, M.D., from the Seoul National University College of Medicine in South Korea, and colleagues evaluated cancer detection rates, cancer characteristics and MRI performance characteristics in 607 consecutive women (median age, 48 years) with breast cancer who underwent breast conservation therapy (BCT). These women had negative mammography and US findings, and most underwent preoperative MRI examinations (91.8 percent).
“The researchers found that MRI detected 11 additional cancers (18.1 cancers per 1,000 women). The positive predictive value (PPV) for recall was 9.4 percent (11 of 117 examinations), PPV for biopsy was 43.5 percent (10 of 23), and the sensitivity and specificity were 91.7 percent (11 of 12) and 82.2 percent (489 of 595), respectively.”