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PSMA PET Scan for Prostate Cancer: A Comprehensive Overview

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PSMA PET scan is a medical imaging tool for detecting prostate cancer. Read the article to learn more about it.

Written by

Dr. Osheen Kour

Medically reviewed by

Dr. Madhav Tiwari

Published At May 9, 2024
Reviewed AtMay 9, 2024

Introduction

Prostate cancer occurs in the male prostate gland, and the condition is often diagnosed with an imaging tool called a PSMA (prostate-specific membrane antigen) PET (positron emission tomography) scan. PSMA is a protein that is found in the prostate gland. The imaging test targets this protein using a radioactive substance, and thus, the PSMA PET scan is considered more accurate and specific than any other diagnostic scan for prostate cancer. The article talks in detail about the PSMA PET scan, its benefits, adverse effects, and limitations.

What Are the Initial Signs and Symptoms of Prostate Cancer?

The signs of prostate cancer include:

  • Urinary incontinence or lack of bladder control.

  • Burning sensation or pain while urinating.

  • Frequent urination, especially at night,.

  • Painful ejaculation.

  • Erectile dysfunction or impotence.

  • Blood in pee or semen.

  • Fecal incontinence or loss of bowel control.

  • Pian in the hip, lower back, and chest.

What Are the Indications of a PSMA PET Scan for Prostate Cancer?

  • The scan helps to diagnose the spread of cancer (metastasis) to other parts of the body and away from the pelvis, where the potential treatment of prostate cancer is through radiotherapy and surgery. However, if the cancer has spread beyond the prostate gland, radiation therapy and surgery are not effective, and the patient needs treatment for the whole body.

  • PSMA PET scan is also indicated for evaluating the patient’s eligibility for a radiopharmaceutical treatment, such as lutetium Lu-177 vipivotide tetraxetan (Lu-177 PSMA), used to target PSMA-expressing prostate cancer. This treatment method is preferred for those individuals who have progressed with prostate cancer during treatment with oral hormones and chemotherapy. However, Lu-177 PSMA is only effective if prostate cancer shows a high level of PSMA expression. Otherwise, the test is the least helpful.

  • The scan can also be used to detect the reoccurrence of prostate cancer in patients who have been treated with surgery and radiotherapy before and have an increasing prostate-specific antigen level. This also helps the healthcare provider and the patient decide whether to go for radiotherapy or systemic treatment.

Who Is Eligible for an Undergoing PSMA PET Scan for Prostate Cancer?

  • PSMA PET is recommended for patients with prostate cancer that has spread to other body parts, as per the biopsy test reports.

  • The imaging test is also advised in patients with a suspected recurrence of prostate cancer, depending on the rise in the patient’s PSA (prostate-specific antigen) levels.

How Is the Patient Prepared for the PSMA PET Scan for Prostrate Cancer?

The PSMA PET scan procedure is effortless, and one does not have to prepare for it in advance:

  • In the clinical setup, the patient is given an intravenous (IV) injection of radiotracer and made to wait an hour for it to be absorbed into the body.

  • Once the patient is ready, they slide into the PET scanner machine. The test takes roughly 30 minutes to scan the body, and the patient can return home.

  • Due to the radiotracer, the patient may feel nausea, dizziness, and diarrhea; hence, the patient is advised to drink enough water to help flush out the medication from the body.

  • The test scan is sent to the nuclear medicine physician for further evaluation.

What Are the Potential Benefits of a PSMA PET Scan for Prostate Cancer?

The benefits of a PSMA PET Scan are as follows:

  • The scan can even diagnose small tumors better than conventional diagnostic methods. Studies show that OSMA PET scans can detect 85 percent of metastatic tumors, whereas computed tomography scans (CT scans) and bone scans can detect only 35 percent of the tumors.

  • The test is specifically linked to prostate-specific membrane antigen, or PSMA, and therefore, the chances of misdiagnosis or false diagnosis of the condition are almost negligible.

  • The test helps people decide the treatment specific to their condition and not undergo surgery or any treatment that is not needed.

  • The results produced by this scan are more likely to be specific anyhow.

What Are the Adverse Effects of the PSMA PET Scan for Prostrate Cancer?

The imaging test is quite safe for most patients; however, it often causes fatigue, nausea, headache, and taste changes, which usually resolve independently. PSMA PET scan may also cause an allergic reaction, especially in those patients who are already allergic to some medications or foods. Additionally, the imaging test also puts a person into a lifetime exposure to radiation, thus increasing the risk of developing cancer in the future.

What Are the Limitations of PSMA PET Scan for Prostrate Cancer?

Though the PSMA PET scan is effective in diagnosing prostate cancer accurately, the scan has a few limitations, such as it cannot always detect prostate cancer because not all of them express prostate-specific membrane antigen, or PSMA, and hence, cannot be detected by the PSMA PET scanning. Another limitation is that prostate cancer is often expressed as some other type of cancer or a non-malignant condition related to it, which often gets misdiagnosed in this procedure. This further leads to inappropriate treatment of prostate cancer due to incorrect or misdiagnosis.

Conclusion

To conclude, prostate cancer can be treated with timely diagnosis and effective treatment. Also, people who have prostate cancer confined to the gland can continue to live liver cancer-free post-treatment for many years. A PSMA PET scan is an advanced diagnostic method to effectively diagnose prostate cancer and its possible spread to other parts of the body. Therefore, the healthcare provider can better guide an individual suffering for the best imaging scan based on their condition and possible risk factors associated with their health condition. Additionally, the scanning test helps the doctor decide the best treatment for the patients depending on their condition and cancer development.

Source Article IclonSourcesSource Article Arrow
Dr. Madhav Tiwari
Dr. Madhav Tiwari

General Surgery

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