PET Scan May Help Detect Prostate Cancer Early

ScienceDaily (Sep. 1, 2009) — A new study published in the September issue of The Journal of Nuclear Medicine shows that positron emission tomography (PET)/computer tomography (CT) scans with the imaging agent choline could detect recurring prostate cancer sooner than conventional imaging technologies in some patients who have had their prostates surgically removed.

In addition, the journal also includes a paper that provides a broader examination of new agents and techniques for imaging prostate cancer, which accounts for 10 percent of all cancer-related deaths in the United States and is the most common type of cancer among men.

Many men diagnosed with prostate cancer choose to have a radical prostatectomy, which involves surgical removal of the entire gland and surrounding tissue. However, prostate cancer recurs within five years in as many as 30 percent of these patients. Physicians monitor patients who have undergone the procedure by checking levels of prostate-specific antigen (PSA) in the blood. If PSA is detected after radical prostatectomy—known as biochemical relapse—then imaging techniques are essential to determine whether and exactly where in the body the cancer has recurred. The study examined PET/CT scans with radioactively labeled choline—a promising molecular imaging tool which has been shown to be more accurate than conventional imaging techniques such as CT, magnetic resonance imaging (MRI) and bone scintigraphy in detecting recurrent prostate cancer.

"In most patients with biochemical relapse after radical prostatectomy, conventional imaging methods often return false-negative results, meaning that the imaging techniques fail to detect cancer that is present in the body," said Paolo Castellucci, M.D., of the nuclear medicine unit, hematology-oncology and laboratory medicine department, Azienda Ospedaliero-Universitaria di Bologna Policlinico S. Orsola-Malpghi, University of Bologna, Italy, and lead author of the study. "Our study found that for some patients, PET/CT with choline can improve the detection of cancer soon after PSA levels are measured. This enables physicians to tailor treatment to individual patients in the early stages of recurrence, thus increasing their chances of recovery."

The study included a total of 190 patients who had undergone radical prostatectomy and showed biochemical relapse in followup examinations. These patients were grouped according to PSA levels and studied with choline PET/CT scans. In addition, researchers also factored in PSA kinetic factors such as velocity—or the rate at which PSA levels change—and the PSA doubling time for each patient.

The study found that whole body PET/CT imaging with choline is significantly better than conventional imaging technologies in detecting prostate cancer in patients with biochemical relapse after radical prostatectomy. Researchers also found a strong association between PET/CT detection of recurrent cancer, PSA levels, and PSA kinetics. The authors suggest that based on the results, only patients with a high probability of having a positive scan based on PSA levels and kinetics should undergo choline PET/CT scans. By using these criteria, the number of inappropriate choline PET/CT scans can be reduced and early detection of prostate cancer relapse can be improved.

A paper examining the state of imaging technologies in diagnosing, staging, and monitoring treatment of prostate cancer is also featured in this month's journal. The paper, based on a recent workshop held at the National Cancer Institute, reviews the technologies in light of growing concerns about overdiagnosing and overtreating prostate cancer. In some cases, detectable prostate cancer is very slow-growing and remains localized in the prostate. The rate of overdiagnosis of prostate cancer—defined as diagnosis in men who would not have clinical symptoms during their lifetime—has been estimated to be as high as 50 percent. In these cases, decisions to treat the cancer could have significant side effects such as impotence and incontinence, which can affect patients' quality of life.

"Conventional imaging techniques such as CT, MRI, and ultrasound leave substantial room for improvement in determining the extent and severity of prostate cancer," said Martin Pomper, M.D., Ph.D., professor in the department of radiology and radiological science, Johns Hopkins Medical Institutions, Baltimore. "New biomarkers may soon rival PSA for monitoring the presence and extent of disease. Our brief review examines the role of new and emerging molecular imaging agents for initially diagnosing, staging, detecting recurrence after treatment and measuring response to therapy."

Despite a variety of emerging techniques and probes using multiple imaging modalities, the paper notes, a simple, accurate method for image-guided therapy within the prostate is still needed. For metastatic disease, more careful study should be conducted of combinations of markers for prostate cancer, such as androgen receptor and prostate-specific membrane antigen (PSMA), which are excellent targets for imaging and therapy. In addition, new selective serum and urinary biomarkers such as the urinary marker sarcosine should be merged with molecular imaging tools.

Pomper adds,"The article by Castellucci, et. al., in this issue illustrates nicely how connecting a serum marker—in this case PSA—with imaging can facilitate choosing the correct patients for an imaging study, as well as cut back on false negative results for that study." A practical multimodality imaging approach, coupled with an array of relevant bioarkers sampled from the blood and urine, will provide the best chance for effective management of prostate cancer, the paper concludes.

5 Ways To Prevent Prostate Cancer

The five-term senator is scheduled to have surgery during the Senate's August recess, the Hartford Courant reported Friday. Sources told FOX News that Dodd "will be fine."

The 65-year-old senator joins thousands of other men who will be diagnosed with prostate cancer this year. The National Cancer Institute estimates that 192,280 men will be diagnosed in 2009, and 27,360 will die from the disease. Those statistics make prostate cancer one of the leading killers of men in the U.S.

Although it’s one of the most common cancers suffered by men, there are ways to minimize the risk of getting it, said Dr. Ihor Sawczuk, chairman of urology and chief of urologic oncology at Hackensack University Medical Center in New Jersey.

Here are five of them:

1. Get Tested. All men age 40 and older should be tested annually for prostate cancer, Sawczuk said.

There are two types of prostate cancer screening: the prostate-specific antigen (PSA) test and the digital rectal exam.

The first test measures the level of PSA in the blood. PSA is a substance made mostly by the prostate. Too much PSA in the blood may indicate prostate cancer. However, high levels of PSA may also be indicative of infection, inflammation or an enlarged prostate.

The second test involves a doctor or nurse placing a lubricated, gloved finger into the rectum to check the prostate for lumps and anything else unusual.

If either test raises a red flag, doctors may follow up with a prostate biopsy. This is the most accurate way of checking for cancer. However the test is invasive and can result in a urinary tract infection, as well as urinary and incontinence problems.

2. Get Plenty of Vitamin D. Spending time in the sun and taking a daily supplement will help men increase their levels of vitamin D and possibly reduce their risks of prostate cancer.

“Vitamin D has been shown to inhibit prostate cancer cells in the laboratory,” Sawczuk said.

Calcium may reduce the amounts of biologically active vitamin D in the body, so milk drinkers should also look for additional sources of vitamin D, which can be found in cod liver oil, tuna and salmon.

3. Quit Smoking. In addition to harming the lungs and the heart, smoking may also be responsible for the spread of prostate cancer.

A 2003 study from Johns Hopkins University in Baltimore found that men under the age of 55 who had prostate cancer and were current or former smokers were 66 percent more likely to see the cancer spread into other areas of the body.

4. Reduce body fat. Being overweight and maintaining a diet that is high in saturated fat, as well as processed and red meats, are risk factors for prostate cancer, said Sawczuk.

Fatty diets have been found to increase testosterone production, which in turn increases the risk of prostate cancer. Research has also shown that men who consume red meat at least five times a week had a 2.5 percent increase in developing prostate cancer than men who ate red meat less then once a week.

5. Eat a Variety of Healthy Foods. There has also been promising research that shows pomegranate, soy and foods high in lycopene, such as tomato sauce, reduce the risk of prostate cancer, Sawczuk said, adding that maintaining a healthy diet is one of the best ways men can reduce their risk of cancer.

My Prostate Problems Time-Line

Let me start out by giving my viewers the background of my initial signs of a prostate issue:

September, 2007:

I started having some very minor urination problems during this month. They were barely noticeable but more night-time bathroom trips & slight burning during urination where the main signs. I started drinking more water & thought this would clear things up.

October, 2007:

My symptoms started getting worse. I had more night-time bathroom trips & burning during urination. I also started feeling like I was setting on a golf ball at times. I again started drinking extra water daily. I felt better for a short period of time but still symptoms where never gone.

November, 2007:

By this time, things were gradually getting worse. I was only drinking water & green tea at this time. I had no other type fluids going into my body. My symptoms were just getting worse by the day.

December, 2007:

This was getting near holiday time & I wasn't feeling well at all. My burning & bathroom trips were more frequent. I then had additional symptoms of feeling tired & depressed. I wasn't eating regularly & my appetite was going south. I hadn't lost much weight at this time but was showing signs of trouble eating.

January, 2008:

I started feeling very down & depressed. I couldn't do any setting for longer than 10-15 minutes at a time.I would break out into a sweat if I set too long & would feel like I was going to faint. I still was in denial I guess but tried to keep going. I was not very active at all even though I had been active all my life. I was very depressed but still wasn't getting any help because of my denial about having a prostate issue. Men are sometimes too manly to admit there's something going on down there, right? I was starting to think the worse & I was dead-set I had prostate cancer.

February, 2008:

I was getting much worse by this time & was now suffering from fever & chills to go along with all the other symptoms. I then decided it was time to finally try to figure pout what was going on with me. My wife had really fussed at me all the time to go to the doctor. However, I'm a man & we don't admit there's a problem there like I said before.

March, 2008:

After researching on the net for days I decided to make a phone call to a local urologist office. I went to my first appointment on March 28th. I provided a urine sample to go along with blood work. The doctor then asked to do a Digital Rectal Exam(DRE) to check my prostate manually. The word "digital" here doesn't mean by a machine but by the doctor's finger. I knew this wasn't going to be any fun. Upon examination, the doctor stated that my prostate was "very enlarged" & felt soft to the touch. This normally shows a prostate infection & therefore he suggested treatment with antibiotics.

I was given a 3-week course of Doxycycline to treat the supposed infection. BTW, the PSA(Prostate Specific Antigen) test came back with a reading of 0.9 which is below normal for any prostate cancer. Normal is considered between 1.0-4.0 on a scale. Anything above 4.0 is considered abnormal but higher numbers are more serious like 10.0 or higher. That relieved me somewhat for a short time. I will cover this test in detailed later as well.

April, 2008:

After going through the 3-week treatment with antibiotics I did feel quite a bit better. However, about a week after the treatment stopped I started feeling bad again. I was getting back the frequent urination at night & burning during urination along with the golf ball feeling from the testicle area. About 2 weeks later I was right back where I was before with pain from sitting & depressed. I then said I'm gonna study on the net even more about this situation. Doctors like to throw antibiotics into our bodies for all sorts of health problems. Once studying more I was thinking that this wasn't going to make me better or at least allow me to manage my prostate problems.

May, 2008:

I decided I would give the urologist office another call for another appointment. However, I got so sick that I couldn't wait for that appointment & had to make a trip to the ER. I was the sickest I had been now with nausea,pain,sweats,& very depressed. The ER doctor stated that I had been on the wrong antibiotics & changed it to an0ther in the same class. This was also a 3-week course treatment. I didn't keep my followup appointment with the urologist since I was back on antibiotics.

June, 2008:

Once the most recent course of antibiotics was finished I again started feeling bad. This was only about 4-5 days after the treatment stopped. I then started researching deeply on the net about my prostate problems. What I found out was that this was the typical protocol by doctor's for prostate infections. They rarely worked & some people even suffered worse problems from antibiotics. I still decided to call the urologist office for an appointment. I went to this appointment on June 26. I again was diagnosed with an infection & that more antibiotics was needed. I SAID NO THANKS THIS TIME! I told the doctor I was considering alternative treatments now instead of prescription meds.

July, 2008:

After extensive research I decided that I would give herbals a try to see if that route helped. I visited many sites researching the best herbs & herbal brand name products to possibly try. I mean I spent hours daily trying to make sure that I didn't throw money away to these so called scammers. There are tons of products & formulas to treat not only prostate disorders but many health-related problems. I didn't want to go with the wrong products. I found quite a few single supplements/herbs that I started using & I will be going in detail on these in future writings. To be short at this time I started taking about 16 combination herbs & supplements in the month of July.

August-October, 2008:

During these 3 months I kept at taking the herbs & supplements on a regular basis. Boy, I was feeling like a new person compared to the feeling while on antibiotics. I still am only drinking filtered water & green tea all during this time & NOTHING else period. Another thing I need to mention is my DIET. This is also a big factor in managing prostate related illnesses.

I too will be going over my detailed diet in the future. One other thing is LIFE-STYLE change. I will cover all these things at a later time but right now I wanna just give the rundown of my prostate problems & timing. By the end of October I was actually nearly 100% symptom free. I felt like I had my life back again & wasn't worried now about prostate cancer.

November, 2008-present:

Now, I appear to have my life completely back with barely noticeable symptoms. Most of the time I don't even have any symptoms at all. Prostate infections are divided into several categories & I will cover this in future articles. All prostate infections are called "prostatitis" but here is where they get divided into types. These will be covered later. I will provide links to many of the same sites I used & will provide as much help for people that are experiencing the same awful medical problems I went through.

It's not something that any man wants to experience but maintaining prostate performance & health will go a long way towards avoiding issues in the future & also lead the ones suffering back to good health. Looking forward to posting more articles in the near future & I will be back soon with more information. Thanks for reading & have a great day!