Dr. Castle on Staging Modalities for Men With High-Risk Prostate Cancer

Erik P. Castle, MD, professor of urology, Mayo Clinic, discusses traditional imaging modalities and newer counterparts that are used to detect prostate cancer.

Unless a patient with high-risk prostate cancer has a life expectancy of less than 5 to 10 years, they’re likely to undergo treatment, Castle says. For those patients, standard imaging like CT scans and bone imaging are used. However, physicians are slowly transitioning from classic technetium-99 bone scans to sodium-fluoride PET imaging.

There are other PET imaging modalities such as prostate-specific membrane antigen PET; this has yet to be fully FDA approved. Choline C-11 PET is available at Mayo Clinic for patients who have been treated for high-risk prostate cancer and have had a biochemical recurrence. There’s also 18F-Fluciclovine PET/CT.

Using these imaging studies to help better identify patients who are going to benefit from combined therapy with androgen-deprivation therapy (ADT), and the sequence of radiation, surgery, and ADT will become prominent over the course of the next few years.