PSMA-PET Scans May Spare Prostate Cancer Patients Unnecessary Lymph Node Dissection

PSMA PET Scans Show Promise in Guiding Prostate Cancer Treatment

For men diagnosed with intermediate-risk prostate cancer, teh decision of whether or not to undergo pelvic lymph node dissection (PLND) during surgery can be a tough one. While PLND is considered the standard approach for determining whether cancer has spread to nearby lymph nodes, it comes with risks, and many patients ultimately don’t have lymph node involvement.

A New Approach to Prostate Cancer Staging

A recent study published in Prostate Cancer and Prostatic Diseases suggests that PSMA PET scans could offer a valuable choice. PSMA PET scans are a type of nuclear imaging that targets prostate cancer cells, providing a detailed picture of the disease.

“New promising imaging modalities such as PSMA-PET might help to select the right patients for PLND during [radical prostatectomy],” wrote lead authors Reha-Baris Incesu, MD, and Felix Preisser, MD, of the Martini-Klinik Prostate Cancer Center in Hamburg, Germany.

Reduced Complications and Improved Outcomes

The study found that PSMA PET scans have a high negative predictive value (NPV) for detecting lymph node invasion. This means that if a PSMA PET scan is negative for lymph node involvement, it’s highly likely that the patient does not have cancer spread to their lymph nodes.

The researchers investigated whether using these scans to guide treatment decisions could lead to better outcomes. Thay found that men with intermediate-risk prostate cancer who had negative nodal status on their PSMA PET scans experienced positive results.

Can we Revolutionize Prostate Cancer Treatment With PSMA PET Scans?

Exciting new research suggests that PSMA PET scans could dramatically change the way we treat prostate cancer. A recent study found that for certain patients, undergoing a procedure known as pelvic lymph node dissection (PLND) did not lead to better short-term outcomes.

The researchers concluded, “In outcome, the complication-prone procedure of PLND could be spared in selected intermediate-risk patients with a PSMA PET negative for [lymph node invasion].”

This is a significant finding as PLND can carry potential complications like pain, lymphedema, nerve injury, and even blood clots that could lead to strokes. By using PSMA PET scans to more accurately identify patients who truly need PLND,we could potentially minimize these risks.

Looking Ahead: A More Personalized Approach to Prostate Cancer Care

The findings of this study offer hope for a more personalized and less invasive approach to prostate cancer treatment.While more research is needed, PSMA PET scans have the potential to revolutionize how we diagnose and stage prostate cancer, leading to better outcomes for patients.

Ace Hardware Indonesia Rebrands as AZKO After Three Decades

Starting January 1st, 2025, Ace Hardware Indonesia officially rebranded as PT Aspiration Life Indonesia Tbk (AHI) and unveiled its new brand identity, AZKO. This significant change marks a new chapter for the well-known household equipment and tools retail chain in Indonesia.

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The Kawan Lama Group, which owns the retailer, unveiled this new identity to align with its vision for the future. The name AZKO symbolizes the company’s aspirations and dedication to providing quality products and services to its customers. This rebranding is expected to strengthen the company’s market position and enhance its brand recognition both locally and internationally.

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What are the limitations of PSMA PET scans that patients and clinicians should be aware of?

interview with Dr. Emily Carter, Oncologist and Prostate Cancer Specialist, on the Promise of PSMA PET Scans in Prostate Cancer Treatment

Archyde News Editor (ANE): Dr. Carter, thank you for joining us today. Let’s dive right in. A recent study published in Prostate Cancer and Prostatic Diseases highlights the potential of PSMA PET scans in guiding treatment decisions for men with intermediate-risk prostate cancer. Can you explain what makes this imaging technique so promising?

Dr. Emily Carter (EC): Absolutely, and thank you for having me. PSMA PET scans are a groundbreaking advancement in nuclear imaging. They target prostate-specific membrane antigen (PSMA), a protein highly expressed in prostate cancer cells. This allows us to visualize the disease with remarkable precision, even at very small scales. Unlike traditional imaging methods, PSMA PET scans can detect lymph node involvement and distant metastases more accurately, which is critical for staging and treatment planning.

ANE: The study suggests that PSMA PET scans could help determine whether pelvic lymph node dissection (PLND) is necessary during surgery. Why is this notable?

EC: PLND has been the gold standard for assessing lymph node involvement, but it’s an invasive procedure with risks like lymphedema, nerve damage, and prolonged recovery. The challenge is that many patients undergo PLND unnecessarily because not all intermediate-risk patients have lymph node metastasis. PSMA PET scans, with their high negative predictive value, can identify patients who are unlikely to have lymph node involvement. This means we can avoid unnecessary PLNDs, reducing complications and improving quality of life for these patients.

ANE: That sounds like a game-changer. Are there any limitations to PSMA PET scans that patients and clinicians should be aware of?

EC: While PSMA PET scans are highly effective, they’re not perfect. PSMA expression can also occur in non-cancerous tissues, such as the salivary glands, kidneys, and bowel, which can sometimes lead to false positives. Additionally, not all prostate cancer cells express PSMA uniformly, so there’s a small chance of missing some lesions. Though, when combined with other diagnostic tools and clinical judgment, PSMA PET scans offer a significant advancement over traditional methods.

ANE: the study’s lead authors, Dr.Incesu and Dr.Preisser, mentioned that PSMA PET scans could help select the right patients for PLND. How do you see this technology being integrated into clinical practice?

EC: I believe PSMA PET scans will become a standard part of the diagnostic workup for intermediate- and high-risk prostate cancer patients. They provide critical facts that can guide not only surgical decisions but also radiation therapy and systemic treatments.For example, if a PSMA PET scan shows no lymph node involvement, we might opt for a less aggressive surgical approach or even consider active surveillance in certain cases. This personalized approach is the future of oncology.

ANE: What’s next for PSMA PET scans? Are there ongoing studies or developments that could further enhance their utility?

EC: Absolutely.Researchers are exploring ways to improve the specificity of PSMA PET scans, such as combining them with other biomarkers or advanced imaging techniques.There’s also exciting work being done in theranostics, where PSMA-targeting agents are used not just for imaging but also for delivering targeted therapies directly to cancer cells. This could revolutionize how we treat advanced prostate cancer.

ANE: That’s fascinating.what advice would you give to patients who are considering PSMA PET scans as part of their treatment plan?

EC: I’d encourage patients to discuss this option with their oncologist or urologist. while PSMA PET scans are not yet universally available, they’re becoming more accessible, and their benefits are well-documented. Patients should also seek care at centers with experience in advanced imaging and prostate cancer management to ensure they receive the most accurate and comprehensive care possible.

ANE: Dr. Carter, thank you for sharing your insights. It’s clear that PSMA PET scans are a powerful tool in the fight against prostate cancer, and we look forward to seeing how this technology continues to evolve.

EC: Thank you. It’s an exciting time in prostate cancer research,and I’m optimistic about the future for our patients.