Body Scans and Other Predictive Factors

While multiparametric MRI is an excellent tool for monitoring disease inside the prostate, scanning the rest of the body for cancer that may have spread to the lymph nodes or bones is also critical. Body scans are necessary for every Stage of Blue except Sky. Traditionally, doctors have relied on CT scans and bone scans. However, their accuracy is disappointing. Undetected spread is the most common reason for cancer recurrence after the initial treatment.

PSMA-PET scanning technology can be used to detect prostate cancer both inside and outside the prostate. It can be used to add clarity to MRI when staging initial treatment, and it can be used in cases where prostate cancer has spread outside of the gland. It is highly specific to prostate cancer and detects lesions with greater accuracy than any scan. These scans have transformed the management of prostate cancer and can detect disease at a much earlier stage, allowing for more precisely targeted treatments. PSMA technology can potentially change the way that men with local or advanced disease are treated and is a modern component of prostate cancer treatment.

Although PSMA-PET works for most cases of prostate cancer, a small subset of prostate cancer does not express PSMA and therefore other scans must be used. Another FDA-approved scan is FACBC (Axumin), which detects increased amino acid metabolism in the cancer cells. Another PET scan called NaF18 (radioactive sodium fluoride) provides superior specificity and sensitivity when compared with older Technetium-99 bone scans. Unfortunately, it is not usually covered by insurance. Other more esoteric PET scans that may occasionally be considered are FDG and C11 Choline. These scans provide an alternative for men with the uncommon subtype of cancer that is invisible to PSMA-PET Scans.