Axumin for Early Detection of Recurrent Prostate Cancer
Last updated: June 2023
It has been possible for years to use the PSA test and its findings as a potential warning sign of prostate cancer recurrence, but harder to detect specifically where the cancer has metastasized until the PSA had risen to a certain level.
One potential solution
Axumin, a radioactive injection used in conjunction with a PET scan, has helped change this dynamic a bit. The U.S. Food and Drug Administration (FDA) approved Axumin in 2016 for helping detect recurrent prostate cancer. The FDA based the approval on two studies that evaluated the impact of Axumin.1
How Axumin works sounds surprisingly simple (although I’m sure figuring it out from the scientific side was anything but). Axumin enters the cancer cells "and lights up in the PET/CT scan," according to its website. The scan can then be analyzed by an imaging physician to try to identify where prostate cancer may be coming back.2
With which stage of prostate cancer were you last diagnosed?
Identifying the types of recurrence
There are different types of recurrent prostate cancer. One is a “local recurrence” where the cancer is still contained to the prostate, or limited to the prostate bed (if the patient had the prostate removed). Another type is when the cancer metastasizes to other parts of the body, such as the lymph nodes or bones.
Identifying a recurrence when it is still local is optimal, and I think Axumin may increase the odds on this. In addition, even when a recurrence is beyond localized, the hope is that it can be identified, isolated, and the treatment targeted before it spreads further.
No test is perfect
Of course, no test is perfect and Axumin can’t predict metastasis 100% of the time. It also may not detect recurrence at low PSA levels. Further, the interpretation of the results can be subject to human error. That means a "positive" Axumin PET/CT scan may not always confirm recurrence; a "negative" scan may not always rule it out, either. The results should be interpreted carefully by the imaging physician.2
An Axumin scan can take up to half an hour. Possible side effects of Axumin include injection site pain, redness, and a metallic taste in the mouth.1,2
Advancing screening technologies
It should also be noted that while Axumin has been approved for helping locate prostate cancer in recurrence situations, I think it is easy to imagine future uses. For example, I could envision it being used in the future for men with an original diagnosis who have an extremely high PSA and are trying to determine if the cancer has escaped the prostate.
Catching the spread of prostate cancer early can yield to better and more possible outcomes for the patient.
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