• By Dennis Douda

Mayo Clinic Minute: A better look at prostate cancer

September 21, 2017

It is the third leading cause of cancer death for men in the U.S. More than 160,000 new cases of prostate cancer are expected to be diagnosed in 2017. "The reality is that prostate cancer is the most commonly diagnosed solid malignancy in men," says Dr. Eugene Kwon, a Mayo Clinic urologist.

Dr. Kwon says, unfortunately, far too many patients fail their initial treatment for prostate cancer. "The fact is that, after you treat it, it doesn’t necessarily go away. It has a tendency to come back, and, for that very reason, a lot of men get into significant trouble."

A big part of the challenge is locating the cancer when it returns to surgically remove it or zap it with radiation therapy. But technology is giving health care providers something even better than X-ray vision to see where it's hiding.

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Dr. Kwon says, even with aggressive surgery and radiation, tumors eventually return for 40 percent of prostate cancer patients. Even more frustrating, it's unpredictable. "It can come back wherever it feels like it wants to come back," he says.

Which is why Dr. Kwon and his Mayo Clinic colleagues worked so hard to win U.S. Food and Drug Administration approval for C-11 choline. Injected into a vein, the radioactive nutrient concentrates where cancer's hiding, then lights up on positron emissions tomography, also called a PET scan.

"It looks at soft tissues and bones simultaneously," he explains. "It's a 30-minute exam.  Based on our calculations, our C-11 choline can see cancer in the body seven years before any other form of imaging."

Because the dye's radioactivity quickly fades, C-11 has to be made on-site and injected within minutes. Dr. Kwon says it has revolutionized his ability to treat patients. "This is the first time that we’ve ever been able to verify certain treatments are working and certain treatments are not working."

Besides Mayo Clinic's program in Rochester, Minnesota, Mayo hospitals in Jacksonville, Florida and Phoenix have also built cyclotron facilities to manufacture C-11 choline. Both locations expect to be using it for cancer detection and treatment monitoring within the next couple of years.

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