Posts Tagged ‘recurrent prostate cancer’

A New Method to Find the Site of Returning Prostate Cancer

prostate cancer diagram

The yellow arrow and the white arrows on the pictures above indicate areas of prostate cancer that were invisible to previously available imaging techniques. Instead, they were detected using a new positron-emission tomography (PET) test called FACBC, which was developed and is being tested at Emory University.

A voluntary research study is being conducted to help men with recurring prostate cancer by using advanced imaging technology called FACBC to guide radiotherapy and determine the best possible course of treatment. This study would be added as an extra layer in your ongoing cancer treatment.*

We are looking for patients to participate in this clinical trial.

“By participating in this study, patients may have the opportunity to have an FACBC scan. The precision of this type of scan could help guide more effective treatment for patients whose cancer has returned,” says Ashesh Jani, MD, radiation oncologist and principal investigator.

Have you previously had surgery to treat prostate cancer, but think the cancer has returned? Has your doctor recommended radiation therapy as the next step in your care?

Participants must meet specific eligibility criteria:
• You are over 18 years of age.
• You had surgery (prostatectomy) to treat your prostate cancer.
• Your doctor suspects that the cancer has returned (as indicated by a rising PSA).
• Radiation therapy is now being considered as the next step in your care.

The trial is open at these locations: Winship Cancer Institute on the Clifton Road campus, Winship at Emory University Hospital Midtown, Winship at Emory Saint Joseph’s Hospital and Georgia Cancer Center for Excellence at Grady.

*You will be followed for a minimum of three years, with PSA levels checked every six months, in addition to having study-related lab work. There is no cost for the FACBC scan or the Food & Drug Administration (FDA) required lab work. All other imaging, lab work, biopsies (if any), radiation therapy and any other therapy will be billed to your insurance provider or paid out of pocket by you. You may be eligible for a travel voucher if you are chosen to undergo the FACBC scan.

For more information or to enroll, contact Ashesh Jani, MD, at (404) 778-3827 or abjani@emory.edu.

Learn more about Winship’s approach to Prostate Cancer Treatment
Read Winship’s Brochure on FACBC

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Recurrent Prostate Cancer: Where is it?

Tiffany Dunphy and Van Jackson, radiation therapists at Winship at Emory Saint Joseph's Hospital, work with prostate cancer patients undergoing radiation treatment.

Tiffany Dunphy and Van Jackson, radiation therapists at Winship at Emory Saint Joseph’s Hospital, work with prostate cancer patients undergoing radiation treatment.

“It’s a lot easier to plan the attack, if we know where the enemy is,” says Winship urologist Peter Nieh, MD. “If a cancer is still localized, we may want to try salvage therapy, either radiation or surgery, before advancing to something systemic.”

Depending on how primary treatment took place, a prostate cancer often comes back in the prostate bed (where the prostate gland was), and may appear in nearby lymph nodes. In advanced cases, the cancer may spread to the bones.

Emory radiologist and Winship member David Schuster, MD and radiochemist and Winship member Mark Goodman, PhD have been developing a PET (positron emission tomography) imaging probe that shows considerable potential for detecting recurrent prostate cancer.

Usually in PET imaging, radioactive glucose is injected into the body, and since cancer cells have a sweet tooth, they take up a lot of the radioactive tracer. But the tracer also appears in the urine, complicating prostate cancer detection efforts since the prostate is so close to the bladder. In contrast, the probe 18F-FACBC, based on amino acids, is taken up by prostate cancer cells but doesn’t appear as much in urine.

FACBC has its limitations. It also may be taken up in benign prostate hyperplasia or inflammation. This means it probably won’t be as useful by itself for evaluating primary prostate cancers, but it has a lengthening track record in recurrent cancer.

In a 2011 publication, Schuster and his colleagues compared FACBC to ProstaScint, a commercially available probe. FACBC showed superior sensitivity and specificity in detecting tumors outside the prostate bed. Schuster is now collaborating with Winship radiation oncologist Ashesh Jani, MD to study FACBC’s benefits in designing radiation treatments for patients with recurrent prostate cancer after prostatectomy.

In Jani’s clinical trial study for recurrent prostate cancer, which lasts until 2017, one group of patients is examined using FACBC, while another gets conventional imaging. The question is whether using information gleaned from FACBC to direct the radiation results in a longer lasting remission than with the control group.

Marble countertop salesman Paul Reckamp, who was a participant in Jani’s study, keeps a file on his phone noting his PSA levels for the last several years. Reckamp had a radical prostatectomy in July 2010 at Emory Saint Joseph’s Hospital, but the cancer appeared to come back a year and a half later. FACBC imaging confirmed that the cancer had appeared in nearby lymph nodes but not elsewhere, and doctors could then plan radiation treatment that drove his PSA levels back down again.

“I couldn’t have been more pleased with the study,” he says. “It told me and the doctors what we wanted to know.”

As a National Cancer Institute (NCI) designated cancer center, Winship Cancer Institute of Emory University’s participation in clinical trials ensures our prostate patients have access to progressive resources and technology. For men with recurrent prostate cancer, there are newer methods of imaging such as magnetic resonance imaging (MRI) and positron emission tomography (PET). 

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