Getting My Scan Results
Your doctor or nurse will tell you how long it will take for the results of all the tests to come back. Its usually around two weeks.
Your doctor will use your scan results to work out the stage of your cancer in other words, how far it has spread. This is usually recorded using the TNM system.
- The T stage shows how far the cancer has spread in and around the prostate.
- The N stage shows whether the cancer has spread to the lymph nodes.
- The M stage shows whether the cancer has spread to other parts of the body.
What Does An Mri Scan Involve
Before the scan the doctor or nurse will ask questions about your health. As the scan uses magnets, they will ask whether you have any implants that could be attracted to the magnet. For example, if you have a pacemaker for your heart you may not be able to have an MRI scan. Youll also need to take off any jewellery or metal items.
You will lie very still on a table, which will move slowly into the scanner. MRI scanners are shaped like a doughnut or a long tunnel. If you dont like closed or small spaces , tell your radiographer .
The radiographer might give you an injection of a dye during the scan. The dye helps them see the prostate and other organs more clearly on the scan. It is usually safe, but can sometimes cause problems if you have kidney problems or asthma. So let the radiographer know if you have either of these, or if you know youre allergic to the dye or have any other allergies.
The scan takes 30 to 40 minutes. The machine wont touch you but it is very noisy and you might feel warm. The radiographer will leave the room but youll be able to speak to them through an intercom, and you might be able to listen to music through headphones.
How Does A Bone Scan Work
A bone scan is a nuclear medicine test. This means that the procedure uses a very small amount of a radioactive substance, called a tracer. The tracer is injected into a vein. The tracer is absorbed in different amounts and those areas are highlighted on the scan. When cells and tissues are changing, they absorb more of the tracer. This may indicate the presence of cancer.
If the result shows change or damage to your bones, you may need more tests. These tests may include other types of bone scans. A computed tomography scan and a positron-emission tomography scan can be done following a bone scan. Further testing may also include a magnetic resonance imaging , or a biopsy.
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Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.
A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.
While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.
As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.
What To Expect After A Bone Scan
Bone scans do not generally cause any after effects. The dye does not remain active in your body. It passes out of your body through your urine over about 24 hours. You may be instructed to take special precautions after urinating, to flush the toilet twice and to wash your hands thoroughly. You will be advised to drink plenty of water for a day after the scan to help flush the dye out of your system.
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What To Think About
- A bone scan does not distinguish between normal and abnormal bone growth by itself. So bone scan results must be interpreted along with your symptoms and the results of X-ray tests. In addition, other tests such as a CT scan, an MRI, blood tests, or a biopsy may also be needed to further evaluate abnormal bone scan results.
- Some types of cancer or diseases cannot be identified on a bone scan.
Advanced Genomic Testing For Prostate Cancer
The most common lab test for prostate cancer is advanced genomic testing, which examines a tumor to look for DNA alterations that may be driving the growth of the cancer. By identifying the mutations that occur in a cancer cells genome, doctors may get a clearer picture of the tumors behavior and be able to tailor a patients treatment based on the findings.
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Nuclear Bone Scan Procedure
The first step in the procedure is the injection of the tracer material. A technician will do this through a vein in your arm or hand. You might feel a sting from the IV.
Then, you wait for the tracer to travel through your body and bind to your bones. That can take 2 to 4 hours.
Your doctor might order a scan before your body absorbs the tracer for comparison, especially if you could have a bone infection. If youâre having two scans, the first will happen right after the injection.
While your body is absorbing the nuclear material, youâll need to drink 4 to 6 glasses of water to flush extra tracer from your body. Youâll use the restroom before the test so any concentration in your urine doesnât cause a misleading picture.
For the scan itself, youâll lie on a table while a camera takes pictures. Youâll have to remain very still for certain portions of the scan, and you may have to change positions several times. The scanning may take up to an hour. Itâs not painful, but lying on the table may become uncomfortable.
Your doctor may also order a type of test called single-photon emission-computed tomography . The camera rotates around your body to make more detailed images.
How Does The Procedure Work
Ordinary x-ray exams pass x-rays through the body to create an image. Nuclear medicine uses radioactive materials called radiopharmaceuticals or radiotracers. Your doctor typically injects this material into your bloodstream. Or you may swallow it or inhale it as a gas. The material accumulates in the area under examination, where it gives off gamma rays. Special cameras detect this energy and, with the help of a computer, create pictures that detail how your organs and tissues look and function.
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Pet Scans & Bone Scans For Diagnosing Prostate Cancer
Cancer is a very frightening prognosis, and can take quite a toll on the body. Thats why it is important to diagnose cancer as soon as possible, with the hopes that a malignant tumor can be found and dealt with before it metastasizes. When cancer becomes metastatic, the cells start spreading throughout the body, making the task of finding and fighting cancer much more difficult. The process of determining how developed a persons cancer is, and what type, is called staging. The staging process assists the doctor in understanding a patients cancer prognosis and in making the most accurate pathology report and if diagnosed with cancer, it aids them in deciding what kind of treatment is best.
Prostate cancer is the most common type of cancer diagnosed among men, other than skin cancer. Globally, 1.1 million men are diagnosed with prostate cancer each year. This type of cancer is usually slow progressing, but has the potential to spread quickly if left untreated.
Prostate cancer is divided into four stages . These stages tell how far the cancer has spread. Stages I and II are considered early-stage prostate cancer. The cancer has not yet spread outside the prostate. Stages III and IV, indicate that the cancer has already spread to other parts of the body.
What tests are used to stage prostate cancer?
There are 2 types of staging for prostate cancer:
Doctors use the results from diagnostic tests and scans to answer the following questions:
Positron Emission Tomography Scan
A PET scan is similar to a bone scan, in that a slightly radioactive substance is injected into the blood, which can then be detected with a special camera. But PET scans use different tracers that collect mainly in cancer cells. The most common tracer for standard PET scans is FDG, which is a type of sugar. Unfortunately, this type of PET scan isnt very useful in finding prostate cancer cells in the body.
However, newer tracers, such as fluciclovine F18, sodium fluoride F18, and choline C11, have been found to be better at detecting prostate cancer cells.
Other newer tracers, such as Ga 68 PSMA-11 and 18F-DCFPyl , attach to prostate-specific membrane antigen , a protein that is often found in large amounts on prostate cancer cells. Tests using these types of tracers are sometimes referred to as PSMA PET scans.
These newer types of PET scans are most often used if its not clear if prostate cancer has spread. For example, one of these tests might be done if the results of a bone scan arent clear, or if a man has a rising PSA level after initial treatment but its not clear where the cancer is in the body.
The pictures from a PET scan arent as detailed as MRI or CT scan images, but they can often show areas of cancer anywhere in the body. Some machines can do a PET scan and either an MRI or a CT scan at the same time, which can give more detail about areas that show up on the PET scan.
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How Long Does A Bone Scan Take For Prostate Cancer
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What Makes Yale Medicines Work In Nuclear Medicine Unique
We are in the process of bringing a unique prostate cancer imaging agent to Yale Medicine, Dr. Saperstein says. Positron Emission Tomography scans with C11 choline will enable us to more accurately characterize the extent of prostate cancer than ever possible. There are currently no other hospitals in the region that are using this technology.
Beyond Yale Medicines commitment to using the most cutting edge, accurate scanning equipment, Dr. Saperstein emphasizes the level of care patients receive from Yale Medicines radiologists, technologists and staff.
Ive worked in many hospitals, and what Ive really noticed is how everyone on the staff, throughout the department, goes above and beyond to make sure that patients receive compassionate care. Theres a real dedication to patient well-being and comfort,” he says.
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How Long Does The Test Take
A whole body bone scan takes around 3-4 hours, which includes two separate visits. In the first visit you will be given an injection of a radioactive isotope into a vein in your arm. There are no side effects to this injection. The isotope takes 2-3 hours to circulate in the blood and get absorbed in the bone. You will be given a time to return to the Nuclear Medicine Department 2-3 hours after the injection. When you arrive for the second part you will be asked to use the restroom to empty your bladder. You will then be asked to remove all external metal and lay flat on our imaging table for a 30 minute scan from head to toe. We will then review these images with our nuclear radiologist to make sure we have all the information we need. Some additional images may be required.
Preparing For A Nuclear Bone Scan
You can eat and drink as you usually would before your scan. You donât have to do anything special to prepare. But certain things can interfere with the tracer, so tell your doctor if you have:
- Taken an over-the-counter medication containing bismuth
- Recently had a test that used barium
Youâll need to remove jewelry and other metal objects before the scan. You may have to change into a hospital gown.
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Pathophysiology Of Bone Metastases
Spread of prostate cancer to bone is via the haematogenous route, whereby cancer cells initially settle in the bone marrow where they are able to grow in accordance with the seed and soil hypothesis originally proposed by Paget . In bone metastases from prostate cancer, there is predominant upregulation of osteoblastic activity leading to the formation of mineralised woven bone, causing the characteristic osteosclerotic appearance on radiographs and CT, but it is recognised that osteoclasts also play an important part in the pathophysiology of the metastatic growth process . A key mechanism of control is tumour cell influence over osteoblast/osteoclast activity, through the expression of cytokines, including the receptor activator of the nuclear factor-B ligand , an activator of osteoclast differentiation. Increased osteoblastic, osteoclastic, and tumour cell activity are not only therapeutic targets but also represent potential targets for imaging. Other altered imagable bone targets include trabecular bone density, neoangiogenesis, bone marrow fat, water and iron content and tumour related macrophages.
What Are The Benefits Of A Bone Scan
A bone scan helps your doctor evaluate how your bones are working, and provides information to help diagnose and treat your condition. It can show injury to the bones, the effects of disease such as cancer or infection, as well as any improvement or deterioration in a bone abnormality after any treatment you might be having.
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A Genetic Biomarker Test For Newly Diagnosed Prostate Cancer
Results from a study of a different genetic biomarker test suggest that it could one day help inform treatment decisions for men newly diagnosed with localized prostate cancer.
According to findings published February 24 in JCO Precision Oncology, a biomarker test called the Oncotype DX Genomic Prostate Score accurately predicted the long-term risk of metastasis and death from prostate cancer in men with localized disease. The test needs to be validated in larger forward-looking studies before it can be used to guide treatment, the study researchers noted.
How Is A Bone Scan Performed
The procedure begins with an injection of radioactive substance in your vein. The substance is then allowed to work its way through your body for the next two to four hours. Depending on the reason for the bone scan, your doctor may begin imaging immediately.
As the substance spreads through your body, the bones cells naturally gravitate to areas that need repair. The substances radioactive tracers follow these cells and collect in spots where bone is damaged. Its taken up in regions that have a high blood flow.
After enough time has passed, your doctor will use a special camera to scan the bones. The damaged areas where the substance has settled appear as dark spots on the image.
Your doctor may repeat the injection and imaging process if the first round wasnt conclusive. They may also order a single-photon emission computed tomography . This is similar to a bone scan, except the imaging process creates 3-D images of your bones. A SPECT is necessary if your doctor needs to see deeper into your bones. They may also use it if the original images werent clear in certain areas.
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How Long Does A Nuclear Scan Take
A nuclear scan usually takes about 30 to 60 minutes, plus the waiting time after the radioactive material is given.
For bone scans, the material takes 2 to 3 hours to be absorbed. During this time, youll stay in the radiology clinic and will be asked to drink a lot of water to help flush out any tracer that doesnt collect in the bones. The scan itself takes another hour or so.
PET scans take 20 to 30 minutes, but you must wait about an hour while the tracer collects in the organ being studied.
For a thyroid scan, you take the radioactive tracer as a liquid or pill about 24 hours before the scan. The scan takes less than 30 minutes.
MUGA scans can take up to 3 hours, depending on how many pictures are needed.
Gallium scans take several days between the injection and the actual scan. Sometimes people are scanned more than once after the injection. The scan takes 30 to 60 minutes.
Results of nuclear scans are usually available within a few days.