PROSTATE CANCER

They all had prostate cancer but survived thanks to early detection. Nearly one in six will be diagnosed with prostate cancer. The good news? Most prostate tumors can be treated successfully when found early.

Imaging is playing an increasingly important role in that success. "prostate cancer for many years has been maddeningly invisible radiographically, and that is entirely changing," says urologist Bernard Gburek, M.D. "it's changing everything we do in prostate cancer management, and its improving success for the patient."

SMIL is at the forefront of several exciting advancements in imaging that improve prostate cancer detection and increase the effectiveness of treatments.

Precision Imaging Accurate Detection

Men typically do not experience symptoms with early stage prostate cancer, which is why it's important to talk to your doctor screening.

The most common screenings are the digital rectal exam (DRE) and prostate-specific antigen (PSA) test, a blood test.

When prostate cancer is suspected, the physician performs a biopsy, taking 12 to 16 tissue samples from the gland. But tumors can be elusive, and at least 25 percent of the time, cancer is hiding outside the sampled areas.

Fortunately, a new technology called Multiparametric MRI (MP-MRI) helps physicians pinpoint hard-to-find prostate tumors. Guided bt MP-MRI, doctors performing a biopsy use "an innovative method of fusing MRI images and ultrasound images through software," says Nishant Verma, MD, a radiologist with SMIL. "The MRI is almost used to make a roadmap, and the ultrasound is like your eyes helping you drive through the map to get to the cancer."

"MP-MRI has given us a lot of confidence that we can decrease the rate of false negative biopsies (biopsies that miss a hidden cancer," says Dr. Gburek, of Arizona Urology Specialists. "So, we're able to provide earlier intervention and a wider variety of treatment options to the patient."

Treating Recurrence Research Development Collaboration

After treatment, men are monitored with periodic PSA tests. Most receive a clean bill of health, but up to a third of patients experienced recurrence. Unfortunately, The PSA test reveals only that cancer has returned, not whether the tumors are in the prostate, the lymph nodes, the bones, or elsewhere. Techniques such as the bone scan and traditional PET scan have proved imprecise for locating prostate cancer.

New developments, including clinical trials SMIL has been involved in, is changing that. In May 2016, the FDA approved a new PET scan tracer drug, Axumin, that specifically highlights prostate tumors. "This could be groundbreaking for prostate cancer," says Dr. Verma. "It's advanced cancer imaging agent... that should become widely available to essentially anybody and should have a very high chance of detecting recurrence.

In addition, research is continuing to utilize prostate-specific membrane antigen (PSMA). PSMA is found specially on prostate cancer cells and can be used to locate even the smallest assemblies of these cells. This will help radiation oncologists like Gerald Lucas, M.D., of Arizona Oncology. "The big thing with PSMA is that images are going to be more sensitive and specific for detecting some of these local recurrences," he says. "Then we will be able to more accurately target the area of disease with radiation, rather than just treating the prostate bed region."

All these advancements have one goal, says Michael S. Gordon, M.D., a medical oncologist at Pinnacle Oncology Hematology. "everything comes down to improving accuracy, so the decision-making is more consistent and so we as a collective group can make the best possible recommendations to our patients. Within the system- the urologists, radiation oncologists, medical oncologists, and the diagnostic imaging group at SMIL - we're focused on combatting this disease in a comprehensive and collaborative way. We want our patients to know we're committed to bringing to bear all the latest and greatest technologies."