Dr. Koo on New Management Strategies for Prostate Cancer

Phillip J. Koo, MD, division chief of Diagnostic Imaging, Banner MD Anderson Cancer Center in Arizona, discusses new management strategies for patients with prostate cancer.

If a patient presents with biochemical recurrence and a low prostate-specific antigen of 0.5 or 1, conventional imaging will likely show the bone scan or CT as negative, explains Koo. However, if a next-generation imaging agent is used, there is a high likelihood that locally recurrent disease or local metastatic disease will be detected, potentially even detecting oligometastatic disease outside of the pelvis, says Koo.

The next step is to determine how to manage the patient once the test results are received. According to surveys and consensus meetings, such as the Advanced Prostate Cancer Consensus Conference, many providers are treating patients with oligometastatic disease with metastasis-directed therapy and the data regarding this approach are growing, according to Koo. A study from Ghent University showed that the time to initiation of androgen deprivation therapy was longer in patients who had a C11-choline PET/CT scan and then received radiation or surgery on those identified lesions, concludes Koo.