A major question many of us have when we've been diagnosed is whether the cancer has spread beyond the prostate capsule. If it has spread, then local therapies - those treating just the prostate and perhaps the immediate surrounding area, are unlikely to cure the disease. This is not an issue for the majority of us who are diagnosed with low-risk disease; spread is then so unlikely that scans are rarely worthwhile.
However, there are over 200,000 who are newly diagnosed in the US each year, and a substantial portion will have cases that are not clearly low-risk cases, or are intermediate risk cases where there's a real question whether local therapy can be part of the solution. Fusion ProstaScint is one kind of imaging that can clarify the issue, but it has some disadvantages. Combidex imaging was done for several years in the Netherlands, and, while the travel was inconvenient for US patients, Combidex did a superb job of homing in on lymph nodes with cancer. Unfortunately, the company making the imaging medium decided to discontinue that product. The technology proved difficult to master, and a US attempt never panned out.
Now there is a new player on the field, and the new imaging service will be offered, hopefully this year, in Florida. The technology is not the same as Combidex, but is similar, checking lymph nodes in much the same way. It relies on a USPIO fusion CT/MRI image. (USPIO stands for Ultra Small Superparamagnetic Iron Oxide, which is the class of the contrast agent.) The imaging company is not offering this to the public yet, but it is working through a couple of doctors who are sending patients for imaging, in order to work out the technical and logistical infrastructure. The company wants to keep it low-key, not even mentioning it on its website, until all the preparation details have been taken care of.
A friend of mine was one of the first to have this done, and he told us about it at our Tuesday support group meeting. He has been on triple blockade with Avodart for maintenance for several years to counter a recurrence of prostate cancer following radiation quite a number of years ago. His doctor had informed him about research on "oligometastatic" prostate cancer, meaning prostate cancer with just a few metastases. Research has shown in recent years that a number of men with PC mets have such a cancer, and, if the mets can be spotted with imaging, they can be targeted and eliminated with spot radiation. It turned out that the new technology lit up just a few mets for my friend, and he is now on the road to having spot radiation treatment.
This opens up the possibility of a cure for him, or at least pushing the cancer way back!
This bright development highlights several points about the way advanced best treatment is working. It harnesses new technology, in this case both the new Florida facility and the research about oligometastatic prostate cancer. It also shows the value of being able to hold the fort against the cancer until a solution emerges.
I have a hunch this new capability is going to be a game-changer for many of us.