New research hope for patients with recurrent prostate cancer

Date: 22/06/2021

Ground-breaking research looking at the best way to locate recurrent prostate cancer in patients will change the future for thousands of people.

Cabrini Urologist Professor Mark Frydenberg, together with former Cabrini medical student Kavitha Gnanasambantham, were part of the team researching how to locate recurrent prostate cancer in patients and whether it was localised recurrence or in another part of the body.

The research, titled ‘Can paired Ga68 PSMA PET CT Scan and multiparametric MRI enable better diagnosis and treatment of biochemical recurrence post radical prostatectomy?’ is set to be published in coming weeks.

Dr Gnanasambantham who received the Cabrini Medical Staff Research Scholarship to undertake the research, said prostate cancer was the second most common cancer worldwide and had a 30 per cent recurrence rate.

She said the current treatment for men with prostate cancer was a radical prostatectomy, an operation to remove the prostate gland and tissues surrounding it.

Prof Frydenberg said following surgery patients were monitored via blood tests to check for recurrence.

“If the result isn’t zero and is rising, we are concerned there are active cancer cells that have recurred,” Prof Frydenberg said.

“The problem now is we don’t know exactly where the cancer cells are located. It can be localised near the bladder or it could have spread to lymph glands or the bones. The treatment options are very different depending on where it is.”

Dr Gnanasambantham said patients were then usually treated with salvage radiotherapy to the prostatic bed, followed by stereotactic radiation or androgen deprivation therapy.

“Each type of treatment has its own side-effects, they can include urinary incontinence, irritation, inflammation and erectile dysfunction,” she said.

“It’s important to treat the cancer but we don’t want patients exposed to unnecessary therapy. We want to make sure we know where the recurrence is.”

The study, which included 119 patients, looked at 68 Ga-PSMA PET and mpMRI, new imaging modalities that have been proven to detect recurrent prostate cancer more accurately, and whether the addition of the MRI scan had a role to play in picking up local recurrence.

“We looked at the detection rate for each type of scan and it was quite clear that PET scans were good at detecting distant recurrence but not local recurrence,” Dr Gnanasambantham said.

“But the MRI was really good at detecting local recurrence. So pairing them together was the best option. Having both scans improved diagnosis and guided better treatment selection for patients.”

Prof Frydenberg said the research would ultimately change how patients with recurrent prostate cancer were treated.

“It’s much better for the patient to know for sure before they have radiation if that therapy appears unlikely to benefit them based on the imaging results.”

Cabrini Research celebrates an incredible 25 years of Cabrini-led advancements in clinical research this year. This story is one of many highlighting Cabrini’s many researchers who continue to progress towards new treatment options and provide better care, to ensure a brighter health future for all those in need.