New approach identifies returning prostate cancer

In the Journals

For the first time, researchers have mapped patterns of prostate cancer recurrence following surgery, which may help doctors choose the best treatment for men whose prostate cancer has returned. The findings were published online Oct. 5, 2016, by the Journal of Urology.

About 30% of men who have surgery aimed to cure localized prostate cancer will still have a recurrence, according to the researchers. Traditionally, doctors monitor for recurrent cancer using blood tests for levels of prostate-specific antigen (PSA). PSA levels after surgery should be close to zero, and rising levels suggest the cancer has returned. If PSA levels are very high, then finding where the cancer has spread is usually straightforward. But when the PSA level rises just a little, standard imaging tests often cannot detect where that spread has occurred.

To help define the exact areas of cancer spread in men who had a slight rise in PSA, the researchers used a combination of two scanning technologies: C-11 choline PET scanning and multiparametric MRI. The pairing of the two tests helped identify whether the spread was just around the area of the original surgery or farther away.

The newer imaging technologies may allow for quicker detection of spreading cancer, regardless of its location, than conventional imaging and thus help men get early treatment.