When a prostate cancer has metastasised or spread, it has sent metastases elsewhere in the body, typically into the bones or lymph nodes. If the biological characteristics of the cancer and the other risk factors give rise to suspicions that the cancer may have spread (metastasised) via the lymphatic system into the lymph nodes or, most commonly, into the bones, we will stage the cancer before making a final treatment decision.
In prostate cancer staging Docrates Cancer Center takes advantage of the newest and most accurate techniques. These techniques are PET-CT and even more importantly radioactive tracers, which are compatible in particular with the prostate cancer. With the new imaging methods and radionuclide therapies it is possible to treat metastatic prostate cancer efficiently and without any major side effects.
PSMA-PET complements prostate cancer diagnostics
In positron emission tomography-computed tomography (PET-CT), a radioactive tracer is used to examine metabolic differentiation in the body. Because the radioactive tracer seeks out hypermetabolic areas, such as cancer cells, a pronounced infiltration is deemed abnormal in an area where infiltrations are not usually found. Traditionally, staging has involved a contrast medium-enhanced CT scan of the whole body and a bone scan with a gamma camera. Often, the accuracy of cancer staging with CT can be improved through the use of radiotracers. Their use is based on the metabolism of prostate cancer. Sodium fluoride (NaF) is a sensitive tracer for bone scanning.
The new tracer PSMA is particularly sensitive in identifying post-operative or post-radiotherapy recurrences of prostate cancer at very low PSA-levels, as well as the dissemination of early prostate cancer to lymph nodes, etc. The new tracer enables a more accurate diagnosis of prostate cancer. This means that the treatment can be better tailored using methods such as modern radiotherapy, promoting a good quality of life. Being able to accurately locate the cancer is also very important for the surgeon, e.g. when planning a prostatectomy.
The NaF and F-PSMA tests complement each other. NaF is the best option for discovering bone metastases in hard bone tissue, but it does not indicate the location of metastases in soft tissue at all. PSMA, on the other hand, detects metastases in soft tissue, and it can also identify metastases in bone tissue. In some individual cases, the PSMA test has been shown to be a more accurate mode of detecting bone metastases than NaF if the metastases are located in the bone marrow instead of the hard bone tissue.
The doctor always selects the PET tracer on an individual basis.
A multi-professional team
At Docrates Cancer Center a multi-professional team, led by Chief Physician of Nuclear Medicine Jukka Kemppainen, is in charge of the isotope diagnostics and treatments. The permanent staff at Docrates include a radiologist specialised in cancer imaging and a nuclear medicine specialist. This is to ensure uninterrupted and instantaneous dialogue between the imaging experts and attending doctors.
Individual and instantaneous care
An integral aspect of treatment of advanced prostate cancer is a consultation with an oncologist immediately after the diagnosis. Our experienced specialists use reliable examinations to determine, without delay, whether the patient is a candidate for new treatment options and subsequently draw up a tailored treatment plan for each patient.