Featured Research

from universities, journals, and other organizations

Imaging Tool Helps Locate Recurrent Prostate Cancer

Date:
February 15, 2002
Source:
Duke University Medical Center
Summary:
A new multi-institutional study led by investigators at Duke University Medical Center indicates that a diagnostic scan may help localize recurrent prostate disease in men who have had surgical removal of the prostate and show early signs of recurrence.

DURHAM, N.C. -- A new multi-institutional study led by investigators at Duke University Medical Center indicates that a diagnostic scan may help localize recurrent prostate disease in men who have had surgical removal of the prostate and show early signs of recurrence.

This diagnostic scan, called capromab pendetide immunoscintigraphy, trade name ProstaScintฎ, is a monoclonal antibody scan that can detect recurrent disease if it is localized to the area of prior prostate surgery or has spread to other parts of the body. This knowledge can help doctors better decide which type of treatment would work best for each patient with recurrent prostate cancer. The study appears in the Feb. 15, 2002 issue of the journal Cancer.

Surgical removal of the prostate and surrounding lymph nodes — called radical prostatectomy — is an effective way to treat localized prostate cancer and stop the cancer's spread to other organs. If a man is cured with surgery, then his prostate specific antigen (PSA) level should be undetectable. However, according to the American Cancer Society, 40 percent of men have local recurrence of the disease after surgery, and 11 percent are at high-risk of the recurrent disease spreading to other organs. Often, the first sign of recurrent prostate cancer after surgery is an elevated PSA level. The recurrent disease may remain in the local area of the excised prostate (localized recurrence), or may spread into distant lymph nodes or other tissues (distant recurrence).

"When we see a rise of the PSA level in a man who has already had his prostate removed, the first question for the physician is, ‘Where is the recurrent cancer? Has the disease remained localized or has it spread to other parts of the body?' Identifying the location of recurrent disease is important because it can guide clinical management," said Dr. Ganesh Raj, of Duke's division of urology and lead author of the study. Localized recurrence may be treated with radiation therapy while distant disease is usually treated with hormonal therapy.

Currently, when a patient has an elevated PSA level after prostatectomy, he may undergo a computed tomography (CT) scan or bone scan. But CT scans, which X-ray organs of the body, cannot pick up tumor deposits if they are less than 10 to 15 millimeters in size, and bone scans, which take two-dimensional images of the bone, can only pick up a significant burden of tumor cells that have spread into the bones. Both CT and bone scans are often only useful for localization of disease in patients with advanced disease.

"CT scans and bone scans will often come back negative in men with early signs of recurrent disease (low serum PSA)," said Dr. Thomas Polascik, of Duke's division of urology and the senior author on the study. "They may not be clinically useful in this situation."

However, the capromab pendetide scan can detect lesions as small as 5 millimeters and has been shown in earlier studies to detect metastatic prostate disease in men with high PSA levels. However, no prior study had examined its capabilities in evaluating men with mildly elevated PSA levels often indicating early recurrence of cancer.

The retrospective study examined a 75-center database comprising 265 prostate cancer patients who had undergone radical prostatectomies. Patients received no other treatment for their prostate cancer. Ten patients were excluded from the study because lymph nodes were not removed at the time of the prostatectomy.

All but three of the 255 men in the study showed an elevation of PSA levels, the only sign that their cancer might be returning. Recurrent disease was detected by the capromab pendetide scan in 184 of the men (72 percent). Furthermore, in these patients, the scan showed the extent of the disease: One-hundred and nine men (59 percent) had disease confined either to the prostatic bed or the local lymph nodes, while 75 (41 percent) had disease that had spread into distant lymph nodes and/or bone.

Comparisons to other imaging techniques showed that only 11 percent of this group had recurrent disease detected by a bone scan and only 16 percent had recurrence detected by CT scan. These data indicate that the capromab pendetide scan may be more sensitive than the bone or CT scans in identifying the site and extent of disease recurrence in patients with low PSA levels.

"This data is encouraging and shows the clinical utility of the capromab pendetide scan," said Dr. Raj. "A major limitation of this study is the fact that we don't have any histological evidence — for example, no tissue samples of the suspected area of disease — to confirm the scan's results. However, previous studies have shown that a positive scan correlates well with histologic evidence of metastatic prostate cancer."

In addition, the researchers believe that studies with longer follow-up are needed to determine the true clinical utility of capromab pendetide immunoscintigraphy and its impact on clinical outcomes.

Dr. Alan W. Partin, of the Brady Urological Institutes, The Johns Hopkins Medical Institutions, also was a co-author on the study.

Drs. Raj, Polascik and Partin have no financial interest in capromab pendetide immunoscintigraphy. Dr. Partin has served as a consultant to Cytogen, the manufacturer of the scan, in the past.


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Duke University Medical Center. "Imaging Tool Helps Locate Recurrent Prostate Cancer." ScienceDaily. ScienceDaily, 15 February 2002. <www.sciencedaily.com/releases/2002/02/020215070619.htm>.
Duke University Medical Center. (2002, February 15). Imaging Tool Helps Locate Recurrent Prostate Cancer. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2002/02/020215070619.htm
Duke University Medical Center. "Imaging Tool Helps Locate Recurrent Prostate Cancer." ScienceDaily. www.sciencedaily.com/releases/2002/02/020215070619.htm (accessed October 23, 2014).

Share This



More Health & Medicine News

Thursday, October 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) — Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) — Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
US to Track Everyone Coming from Ebola Nations

US to Track Everyone Coming from Ebola Nations

AP (Oct. 22, 2014) — Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
Powered by NewsLook.com
Doctors Help Paralysed Man Walk Again, Patient in Disbelief

Doctors Help Paralysed Man Walk Again, Patient in Disbelief

AFP (Oct. 22, 2014) — Polish doctors describe how they helped a paralysed man walk again, with the patient in disbelief at the return of sensation to his legs. Duration: 1:04 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins