Why Men With Advanced Prostate Cancer Should Get the Hugely Important New PSMA PET Scan

The PSMA PET scan is like a high-tech camera for spotting prostate cancer. It uses a special radioactive substance that seeks out prostate cancer cells. These cells often have lots of Prostate-Specific Membrane Antigen (PSMA), a protein produced by the cancer cells on their surface.

In this scan, cancer cells glow on the camera thanks to the PSMA, revealing their exact location and extent of spread. This enables doctors to see the cancer’s size and spread, catching even small metastases, or spread to other parts of the body, that CT or bone scans sometimes miss.

How Does the PSMA Work?

When you have a PSMA scan, you will be given a special tracer. This tracer is a small, safe molecule tagged with a bit of radioactive material. It’s injected into the body, usually through a vein in the arm. Designed to stick to PSMA proteins, it targets those proteins found on prostate cancer cells.

Once in the body, the tracer travels around and attaches to these cancer cells. As it binds to the cells, the tracer emits a signal that is transformed into clear images, pinpointing the cancer cells’ locations for your doctors. They use this vital information to help plan your diagnosis and treatment.

What’s it Like to Get a PSMA PET?

Before your scan, you might need to follow certain dietary rules or drink more water. This helps your doctors get clearer images.

On scan day, you get the radioactive tracer injected, usually through an IV drip in the arm.

Then, you wait about an hour to give the tracer time to spread and stick to any cancer cells.

Next, you lie on a table that goes into the PET scanner, a large machine with a circular opening in the center, resembling a donut. As the table slides into the scanner’s opening, it circles around you, picking up signals from the tracer. This part is painless and takes 30 minutes to an hour.

Afterwards, the scanner’s information will be translated into detailed body images for your doctor to read. This will show where the tracer, and thus the cancer cells, are located.

Once the scan’s done, you can go back to normal activities. The tracer breaks down and leaves your body within a few hours.

Benefits of PSMA PET in Prostate Cancer Diagnosis & Management

The PSMA PET has numerous benefits for detecting cancer, understanding the spread of the disease, and guiding treatment decisions.

• Better Detection: PSMA PET has shown exceptional accuracy in detecting both primary and metastatic prostate cancer. It  has “… transformed the way we think about prostate cancer,” Dr. Alberto Vargas, a radiologist who specializes in oncologic imaging at NYU Langone Health told SurvivorNet. “Things that we were previously unable to detect because they were so small with other modalities, all of a sudden, light up.”
• Improved Staging: Staging shows how much the prostate cancer has grown and spread. The PSMA PET scan gives clear details about this, helping doctors choose the best treatment.
• Informed Treatment Planning: The information from the PSMA PET scans will help make important treatment decisions that might include surgery, radiation therapy, and other types of therapy.
• Monitoring Treatment Efficacy: PSMA PET can also help see if the various treatments you undergo are working. This can also help your doctors make necessary changes to ensure you get the most effective results.

PSMA PET vs. CT Scan in Prostate Cancer

Before the  PSMA PET scan came into wider use,  doctors usually relied on Imaging from a Computed Tomography, (CT ) scans, to detect, treat, and monitor  prostate cancer.

Doctors now often prefer PSMA PET scans because they are very good at detecting prostate cancer early, even when CT scans and other tests show little or miss the cancer altogether. They also can reveal more cancer than initially expected.

The PSMA PET is especially accurate for finding out whether prostate cancer has spread. Knowing this early helps doctors treat it better and faster, stopping it from getting worse. By giving a more complete picture of the cancer, doctors have a better understanding of what they are dealing with. It helps them create tailored treatments for you as an individual patient.

However, this test is not always as easy to use due to limited availability and higher cost — even though in some cases they can be more cost-effective.  For veterans, these scans are increasingly available through the VA healthcare system.

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