Published on July 01, 2019

Discovering Recurrent Prostate Cancer Earlier

Despite advances in treating and curing prostate cancer, the disease recurs and spreads in some men. Now, Concord Hospital offers the latest technique for detecting the disease for those patients — a technique typically only available at major urban medical centers.

Historically, if doctors suspected prostate cancer had returned in men previously treated for the disease, patients underwent bone scans and CAT scans to determine if the cancer had recurred and if it had metastasized, or spread to other areas of their body. The distinction is crucial in determining the appropriate treatment.

Traditional PET scans, which are more sensitive than bone or CAT scans, are useful in identifying other types of cancers, but not as helpful in detecting prostate cancer. Now, a PET scan using a new identifying element, available only within the past year, enables doctors at Concord Hospital to identify metastatic prostate cancer at a much earlier stage and begin treatment much sooner.

“We have CAT scans and bone scans, which are still the standard of care, but we now have something that is even better,’ said Dr. Amichai Kilchevsky of Concord Hospital Center for Urologic Care. “We can do one test and accomplish what two tests were doing in a more efficient and more accurate manner.”

The enhanced PET scan uses a liquid chemical called a nuclear tracer that is absorbed by prostate cancer cells that may have spread anywhere in the body. The absorbed tracer essentially glows on scan image, pinpointing any prostate cancer sites.

“Very few institutions perform this test because it requires a lot of coordination by the urologist, the medical oncologist and a radiologist who is specially trained to read nuclear medicine tests,” said Dr. Kilchevsky.

“We are unique for our type of practice being able to offer this here, outside a major city,” he said. “It’s a pretty amazing accomplishment.”

The test is important because confirming or ruling out whether the disease has spread determines whether treatment will focus on the prostate alone or address metastatic disease earlier than in the past.

“The bottom line is that the more information we have about a patient’s cancer status, the better decision we can make in terms of how to guide that patient through what could be a very complicated decision,” Dr. Kilchevsky said.