Detecting more prostate cancer earlier with PSMA PET Scans

Prostate cancer doesn’t always require aggressive treatment. Most men can delay complex treatment until necessary through Active Surveillance according to a new longitudinal study in the UK. Early detection of PCa, however, is critical to keeping treatment options open.

Digital rectal exams (DREs) are one of the most common screening methods for prostate cancer alongside prostate-specific antigen (PSA) levels, but research has shown that these combined methods are less effective at detecting prostate cancer, particularly in its early stages. DREs may miss small or early-stage tumors. It is also important to note that a high PSA level does not always mean the presence of prostate cancer.

One of the newest technologies for early detection is the PSMA PET scan. This imaging technique, a hot topic at last month’s American College of Radiation Oncology (ACRO) 2023 convention, is revolutionizing the way doctors diagnose prostate cancer by helping detect it earlier than ever before.

PSMA stands for prostate-specific membrane antigen, a protein found on the surface of prostate cancer cells. The PSMA PET scan utilizes a FDA-approved radioactive tracer, typically Gallium-68 or Fluorine-18,  that attaches to PSMA and shows up on imaging tests. By highlighting the presence of PSMA, the PSMA PET scan can detect small or early-stage prostate cancer cells that might be missed by conventional imaging techniques. 

Conventional imaging techniques, such as CT scans, bone scans, and MRI, can detect structural changes in tissues and bones but are often limited in their ability to identify small or early-stage tumors or differentiate between cancerous and non-cancerous lesions. PSMA PET scans are also less invasive with fewer side effects than other imaging techniques. For example, bone scans require an injection of a radioactive tracer and can cause discomfort or allergic reactions in some patients.

PSMA PET scans provide more accurate information about the extent and location of cancer cells, which is crucial for determining the best treatment plan, including surgery, radiation therapy, or targeted therapy. Additionally, PSMA PET scans can help monitor the progression of prostate cancer and detect recurrence earlier, allowing for prompt intervention.

There is some doubt among urologists, however, surrounding the limited availability of longitudinal data on PSMA PET scans.

“I think a PET scan is helpful, but I am a little bit cautious about understanding the broad spectrum of true positive and false positive within the PET PSMA space,” said Edward M. Schaeffer, MD, PhD, at Northwestern Medicine. “I think we’re just learning about what’s the spectrum of what you can see.”

While PSMA PET scans show increasing promise of early PCA detection, it is only the first step in managing the disease effectively. Other tools and support are needed to determine the best treatment options, as the stage and aggressiveness of the cancer can vary widely. 

Myriad’s UroSuite™, a comprehensive suite of testing across the spectrum of prostate cancer care, offers these types of tools alongside best-in-class support and specialists. With ease of ordering both germline and somatic testing in one seamless experience, doctors can be confident in navigating personalized prostate cancer journeys and reaching the best possible outcomes.