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Prostate Cancer: Clinical Questions and Imaging Answers

Abstract

Prostate cancer is now the commonest cancer in humans and the third commonest cancer after breast and lung cancer; both the frequency and incidence are increasing. The three main clinical questions are: (1) What is the extent of prostate cancer when radical surgery is proposed? (2) Where is the disease when there is a rising PSA and a normal bone scan and radiology? (3) What is the significance of a PSA which is in the normal range but non-zero after radical prostatectomy or radical radiotherapy? Staging is important. The prognosis falls from 80% five-year survival to 30% five-year survival if a single node is involved with prostate cancer. The imaging questions therefore are: (1) Is the prostate capsule breached? (2) Is there local node involvement? (3) Is there extra pelvic node involvement? (4) Is the skeleton involved? The last question is usually answered with the methylene diphosphonate Tc-99m MDP) bone scan. A recently positive bone scan will reflect the presence of metastases, whereas a persistently positive bone scan may represent the healing process continuing and the effect of hormonal therapy, rather than persistence of active metastases. Painful bone metastases may be treated using Strontium 89, or Sm-153 EHMDP radionuclide therapy.

Author

K E Britton, A R Granowski, A Canizales, and M Granowska

Contact Details

Corresponding address:
Department of Nuclear Medicine,
St Bartholomew's Hospital
London
UK

Reference

ICIS Cancer Imaging Volume 2
DOI: 10.1102/1470-7330.2002.0003

Date Posted

31 July 2002

Open Access is provided for this article.

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