On this interview, Brian T. Helfand, MD, PhD, discusses the position of PSMA-PET imaging in tailoring therapy plans for sufferers with prostate most cancers. Helfand is a urologic oncologist at NorthShore College Well being System in Chicago, Illinois.
Video Transcript:
I feel plenty of the trick of prostate most cancers is that if we will see the place the situation of a tumor is, that is going to assist determine the place we must always focus our therapy. I feel that that is smart. And positively, [where] that comes into play is that should you solely have a tumor that is localized to the prostate, that we will see even with the fanciest PSMA-PET imaging, we really feel higher that we could not should deal with different areas, particularly when within the staging setting of a high-risk or very high-risk tumor. Actually, once we speak in regards to the biochemical recurrence tumor the place today, now we have extra focal therapies, definitely, we need to goal these therapies, together with SBRT, to different websites that we might even see. We will intensify the therapy, so to say in these settings to say that if now we have a biochemical recurrent scenario the place now we have a rising PSA after a prostatectomy, we do a scan, and we see that there’s restricted uptake within the prostate mattress, however there is a lymph node that will both be within the pelvis or definitely distant, we will then make our plan based mostly on that. That plan could embody an intensification and along with radiating the pelvis, you may very well radiate that space, if potential or possible.
Then it additionally begs the query, should you see that, how a lot hormone remedy within the N1 or M1 or M0 sort setting, and once more––relying on that scenario and what the pictures present––that you’d really supply that affected person. I feel it definitely adjusts that plan as a result of once more, once we know that there is illness current, particularly in M1 setting, we will contain an intensification with extra prolonged hormone therapies, and so on. I feel that is actually taking part in a task within the choice for the place we’re localizing our radiation therapies in addition to the addition of ADT plus an androgen receptor pathway inhibitor, ARPI, and the period of those therapies. I feel the intensification and even de-escalation once we do not see these ailments is kind of applicable and our pure response to these imaging outcomes.
This transcription has been edited for readability.
