This month, Prostatepedia is talking about newer imaging techniques for prostate cancer. As our ability to image prostate cancer becomes ever more precise, controversy over what to do with this newer information is coming to the forefront. Also at stake are whether or not American insurance companies will pay for newer scans. When a man’s insurance doesn’t cover an imaging study, many patients with the financial means are paying for the scans themselves and often traveling to sites within and outside of the United States.
When your PSA begins to rise after initial treatment, you have what is called a biochemical recurrence. If you’re scanned with one of these newer imaging techniques—the Gallium-68 PSMA, for example—and discover 1 or 2 spots of metastases, you have what is called oligometastatic disease.
Prostate cancer experts are divided on how to treat men with only a few metastases. Traveling—and paying out of pocket—for a scan when doctors are still grappling over what to do with any information such a scan would reveal—may not be the wises course of action. Unless, of course, you understand that the scan results may just be interesting information for you and your doctor to consider and will not necessarily change your course of treatment immediately.
Drs. Thomas Hope and Stefano Fanti help us place PSMA imaging and the controversies mentioned above within the context of conventional prostate cancer imaging and treatment. Dr. Fanti’s offers us the European perspective: imaging has been more widely available in the United Kingdom and continental Europe. Many Americans are now traveling to these countries to obtain newer imaging studies. Dr. Nina Tunariu, of the United Kingdom, talks about whole body MRI as a way of staging prostate cancer. She also offers a note of caution for Americans traveling abroad for scanning.
Dr. Rodney Ellis talks about how newer imaging techniques are changing the treatment landscape at the community level. UsToo offers the support group network and patient advocacy’s view of how imaging impacts prostate cancer diagnosis, staging, and treatment.
And finally, Mr. John Moore talks about his prostate cancer journey and the experience of traveling from his home in North Carolina to California for imaging studies.
The bottom line is that more information is always useful. Newer imaging techniques are detecting cancer in smaller and smaller amounts. How to treat these small amounts of cancer is still under debate, especially since the side effects of prostate cancer treatment can be particularly difficult for many men. If you have the means to obtain a newer scan, do so: but understand that there are controversies over the meaning of their results within the global prostate cancer community. A frank and open discussion with your doctor about what you’ll do with any information you learn before you get scanned is the wisest course of action.