Bon Secours St. Francis’ new prostate cancer imaging helps effectively treat the disease
The silent killer: Prostate cancer repeatedly gets this label because it can develop without presenting noticeable symptoms.
“It’s not until men have very advanced prostate cancer that they start to have symptoms from it,” says Dr. William Lowrance, a urologic oncologist with Bon Secours Hematology and Oncology at the St. Francis Cancer Center. Urinary tract symptoms, such as difficulty urinating, usually come from a benign enlarged prostate, not cancer, he adds.
Prostate cancer develops when the DNA of cells in the prostate—a part of the male reproductive system found just below the bladder—undergo specific alterations. It is the most common cancer in US men, other than skin cancer. About one in eight men will be diagnosed during their lifetime, and the risk increases “as you age,” Lowrance says. Most diagnoses occur after age 65, “but it can also impact men in their 40s and 50s,” he adds.
That’s why men ages 45 and up should get “screened, using a prostate-specific antigen, or PSA, blood test,” Lowrance says, adding men with increased risk factors should start screenings at 40. That includes African American men, men whose fathers or brothers have prostate cancer, and men with certain gene mutations, such as the BRCA1 and BRCA2 (breast cancer) genes.
Patients with abnormal PSA test results will get a prostate MRI, which will show if a needle biopsy is necessary. If it finds cancer, doctors will determine the best treatment based on a man’s biopsy results, age, and overall health. Options can include hormone medications, radiation therapy, or robotic prostatectomy, a minimally invasive surgical procedure.
About half of diagnosed prostate cancers are “very low risk, and we just watch them with a program called active surveillance. You don’t treat them with surgery or radiation because diagnosed men live with it, and it’s highly unlikely ever to cause them any problems,” Lowrance says.
Bon Secours St. Francis now offers prostate-specific membrane antigen (PSMA) imaging for patients with more aggressive forms. It looks for PSMA, a protein that is found on healthy prostate cells but appears in larger quantities on cancer cells.
During the imaging, a patient is injected with a radioactive tracer that PSMA cells attract. This allows doctors to more easily detect the presence of cancer cells and determine their location.
“It’s the best way we have now, before we remove or radiate a prostate, to check and make sure the cancer has not spread. Because if it has, the treatment recommendations are quite different,” Lowrance says.
The imaging can also help doctors more easily find a cancer recurrence in patients who have had their prostates removed or radiated but have another abnormal PSA result. The bone and CT scans doctors previously used often couldn’t find the cancer until “the PSA level got really high, and there was a mass that you could see,” Lowrance says.
“We can now perform these PSMA scans at very low recurrence levels,” he adds. “It’s really changed a lot about how we treat and diagnose prostate cancer.”
To learn more about prostate cancer services at the St. Francis Cancer Center, visit bonsecours.com/locations/specialty-locations/cancer-care-oncology/st-francis-cancer-center.
