C-11 Choline PET-CT scan

I am seeing for a third time a presentation of the C-11 Choline PET scans. These are not normal PET scans. Choline is a new contrast that is providing a new and exciting way to detect metastatic prostate cancer in cases with PSA as low as 1. Much has stated here are HW about Combidex and Faraheme based scans for lymph node detection. The problem is that they stop there. C-11 Choline in a PET scan can show not only micro LN invasion but also micro spreads to bones. There are only a couple places in the US to receive these scans but an open clinical trial is available at Wake Forest University.

Here is that trial information
http://clinicaltrials.gov/ct2/show/NCT00804245

This is a good news bad news post. The good news is in the text above. However, I was a bit perturbed by the presenter from the Mayo Clinic in Rochester MN. Two weeks ago I saw the same presentation by Eugene Kwon from Mayo. At that time I raised a question that I had found an ongoing clinical trial for C-11 Choline PET scans going on at Wake Forest University. Kwon had no idea that this effort was happening. Today's presenter Paul Peller from Mayo was caught off guard when I brought it up again. A top medical industry consultant and the author of the Infolink articles, Mike Scott, is also here and to do a brain check I ran this stuff by him. I asked him why do I know this with a simple search in Google and a major research institute doc. does not? Mike had a two word answer ~ Tunnel Vision...

Ugh...

I have a new discovery in the research of prostate cancer ~ Google.com, seems more docs need to know about it...


Tony

Chris,
You hit the nail on the head. The reason for this test is for men with high risk disease characteristics to be able to identify where additional therapies may be needed and whether systemic treatment may be needed. Right now you can join the Wake Forest trial or contact the Mayo Clinic and ask for doctor's Eugene Kwon or Paul Peller and see if you can get the scan.

Is it perfect? No. It can't detect a single cell and it may miss tumors that are very small. We are waiting to see the results of the trials and that won't happen until 2012. This was presented at PCRI and again here at the ZERO Summit. So it sounds promising but we can't get over joyed with it. Imaging scans thus far for PCa have been less that perfect...

This is NOT a standard PET scan so just getting one that is already approved is not going to get the benefits of this new contract.

Tony

Chris I don't think this test will have us chasing the cancer around our bodies to the point of eradication particularly in advanced cases. We still need to try to get to the cancer before it leaves it's point of origination. But improved imaging contrasts and technologies may strengthen our approaches in controlling mets and improving quality of life. As the presenter stated C-11 Choline doesn't see one cell it finds pockets of many. We keep looking for that perfect imaging test but we are years away from anything resembling it. Even if we could get digital displays in high enough resolution to map the human body, we won't ever be able to analyze it well enough as it is impractical to examine minute particles to see if the are malignant.

But I remain hopeful that we can keep improving these technologies to the point that they allow us more time and better management. I saw a lot of slides and screen shots. It certainly is interesting. These are the best images I have seen to date... But I'm no doctor...

Still my disappointment rings. Two very established research institutions are studying the same thing completely unaware the other is doing it. Sounds like I turned a stone today that surprised the research doctor. If he was truly unaware that Wake Forest had the same research going on, he is probably getting on the phone tomorrow to discuss it. But the call won't be to Wake Forest necessarily ~ it may be to the manufacturer of the contrast...

Tony

Tony - You mention that this test is performed in only a couple of places in the country. I'm currently trying to find a facility to perform this scan for my husband. Do you know where it is offered?

Thank you!
Amy

The trial is not available, but the scan is. I know it is offered at Mayo in MN but I'm trying to find out if it is offered at any other locations.

Thanks,
Amy

Tony - I believe Wake Forest only offers it in the trial which is not recruiting, but I'll double-check.

Thanks for responding!
Amy

So far I haven't gotten much past the phone-answerers at Mayo but have been able to determine that they do offer the scan. They say that it must be scheduled by our Doctor so I've left a message with our Oncologist's office to assist. I asked if it is typically covered by insurance and got the pat answer that I would have to check with my insurance company, something I am loathe to embark on because I just have a feeling they won't know what I'm talking about. I've left a message with the estimating department at Mayo to try to find out what the cost will be if it is not covered.
I did speak to the imaging dept at Wake Forest and the tech had heard of it but said it's in research and not open to the public which is what I suspected.

I will update my progress.

Thanks 142 - Unfortunately our Oncologist is not in network and did not prescribe this procedure. We asked about it at our last mtg when PSA went up again and he was very interested in having us do it, but I guess we're on our own to get it arranged. I am still asking for their assistance however.

Amy

David - I'd be interested to hear so please do keep us posted.

Thanks,
Amy

David,

Refresh my memory---where exactly is your pain?

David,

Pain is bad enough because of the physical discomfort, but I'm sure it works on you mentally as well. When you have pain, it's a reminder of PC, whether it is related or not.

I have aches and pains that I associate and truly believe are directly related even though since day one all of my docs thought I was nuts. I've been amazed how they didn't want to hear about them. My pain is definetely not as bad as yours. Never been more than a 3 out of 10.

Here's my rundown-never a pain at the area of my one spot.

- lower back, both sides...noticed a long time ago I sweat a lot there when working out...never used to.
- tingling sensation in lower back sometimes.
- butt feels like it goes to sleep, discomfort at times
- I feel best when not sitting.

A few months before my surgery I had odd pains in between my thighs at times...docs said not related...surgery took that pain away.

Not sure why I'm saying all this. I guess just to compare notes and perhaps get to the underlining cause and find some relief for you.

My wife has her hands full with pain also (went through a tornado). She gets nerve blocks that seem to really help her. Have you tried that angle?

Jerry

Concerned,
This was a different C-11 PET-Scan. The key to ask is what contracting agent was used in your dad's scan, In this post we are talking abut Choline.

The C11 PET Scan is not new technology. What is being investigated is whether using Choline is doing better than previous agents and it is my understanding that it is indeed producing very good results. Best yet for PCa.

Tony

Hi there,

Yes. I understand the PET/CT is not new but the dye is. We are going to confirm which dye was used. At first I thought it was F-18...but then they told us this was a new dye. His was done pro bono as part of research through Wayne State. He actually had it done at the Children's hospital. Anyhow, the tech told Dad this was only the second one he had done this year since they weren't doing many of them.

I'm going to ask for a copy of the report to see which dye was use. We should have the results today or tomorrow.

I'm not sure it was the C-11 but hoping it was!