DUTASTERIDE

DUTASTERIDE

Generic Name : DUTASTERIDE

Pronunciation : doo tas' teer ide

TradeName : DUPROST soft-gelatin caps DUTAGEN cap DUTALFA Combikit DUTAS cap STERDU cap VELTRIDE tab

Why it is prescribed (Indications) : This medication is prescribed for an enlargedprostatetreatment. It blocks the production of a natural substance that enlarges theprostateand reduces the need forsurgery.

When it is not to be taken (Contraindications) : Severe liver impairment; pregnant women, children, adolescent.

Read more:DUTASTERIDEhttp://www.medindia.net/doctors/drug_information/dutasteride.htm#ixzz12LUmPCjA

Enlarged prostate: Dutasteride-tamsulosin combination therapy more effective

Enlarged prostate: Dutasteride-tamsulosin combination therapy more effective

Like any successful team effort, the best qualities of two drugs commonly prescribed for enlarged prostate yielded better results than either of the medicines alone, according to a new study from UT Southwestern Medical Center.
The findings, published in a recent issue of the journal European Urology, compared treatments for three groups of study participants with enlarged prostates over four years. The study, which included more than 4,800 men, is one of the first to compare single and combo medication regimens in such a large group.
The first group of study participants received the drug dutasteride; the second group received tamsulosin; and the third received a combination of the two medicines.
"We found the combination therapy to be superior at reducing risk of BPH progression," said Dr. Claus Roehrborn, chairman of urology at UT Southwestern and lead author of the study. "The two medications joined forces in terms of symptom control. On the strengths of both dutasteride and tamsulosin, participants reported fewer symptoms, and we observed a 25 percent reduction in prostate volume."
Dr. Roehrborn added that subjects who received the combination therapy also showed a 50 percent reduction of prostate-specific antigen (PSA), a protein produced by both cancerous and noncancerous prostate tissue. PSA levels can be an indication of increased risk ofcancer because cancer cells usually make more PSA than do benign cells, causing PSA levels in the blood to rise. Should PSA levels continue to rise after beginning therapy, patients should be monitored closely because the combination medicines do lower PSA readings, Dr. Roehrborn said.
Enlarged prostate, also called benign prostatic hyperplasia (BPH), is a common urologic condition that affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80.
Symptoms of the condition can be prolonged and severe. Prostate enlargement creates pressure on the urethra, making it difficult to urinate, which can lead to acute urinary retention. This retention causes a host of other problems, including extreme discomfort and infections.
Researchers also looked at the data to determine if the number of study participants needing surgery for BPH decreased with the combination medication regimen. Compared with tamsulosin alone, the combination of drugs reduced the incidence of acute urinary retention by 67 percent and reduced the need for BPH-related surgery by 70 percent.
"We found a 65 percent decrease in the relative risk of acute urinary retention or BPH-related surgery compared with tamsulosin alone and just over a 19 percent reduction compared with dutasteride alone," said Dr. Roehrborn.
Those taking the combination of drugs also were less likely than those in the other two groups to discontinue therapy, he said. Participants themselves noted that the combo medicines were most effective at reducing symptoms.
"There is currently no combination drug for doctors to prescribe for these patients," Dr. Roehrborn said. "This research should provide physicians better information when they decide on a course of treatment for patients with BPH."
Source: UT Southwestern Medical Center

The Effects of Dutasteride, Tamsulosin and Combination Therapy on Lower Urinary Tract Symptoms in Men With Benign Prostatic Hyperplasia and Prostatic Enlargement: 2-Year Results From the CombAT Study

CLE

The Effects of Dutasteride, Tamsulosin and Combination Therapy on Lower Urinary Tract Symptoms in Men With Benign Prostatic Hyperplasia and Prostatic Enlargement: 2-Year Results From the CombAT Study

Claus G. Roehrborna†, Paul Siamib‡, Jack Barkinc†, Ronaldo Damiãod†, Kim Major-Walkere†, Betsy Morrille†,Francesco Montorsif§, CombAT Study Group

Received 30 June 2007 published online 13 December 2007.

Refers to article:

Mechanisms by Which a Phytotherapeutic Drug Influences Bladder Activity in Rats , 14 December 2007 Kimio Sugaya, Saori Nishijima, Shinsuke Tasaki, Katsumi Kadekawa, Minoru Miyazato, Yoshihide Ogawa The Journal of Urology February 2008 (Vol. 179, Issue 2, Pages 770-774) Abstract | Full Text | Full-Text PDF (156 KB)

Purpose

We investigated whether combination therapy with dutasteride and tamsulosin is more effective than either monotherapy alone for improving symptoms and long-term outcomes in men with moderate to severe lower urinary tract symptoms and prostatic enlargement (30 cc or greater). We report preplanned 2-year analyses.

Materials and Methods

The CombAT study is an ongoing, multicenter, randomized, double-blind, parallel group study. Men 50 years or older with a clinical diagnosis of benign prostatic hyperplasia, International Prostate Symptom Score 12 points or greater, prostate volume 30 cc or greater, total serum prostate specific antigen 1.5 ng/ml or greater to 10 ng/ml or less and peak urinary flow greater than 5 to 15 ml per second or less with a minimum voided volume of 125 ml or greater were randomized to 0.5 mg dutasteride, 0.4 mg tamsulosin or the combination once daily for 4 years. Symptoms were assessed every 3 months and peak urinary flow was assessed every 6 months. The primary end point at 2 years was the change in International Prostate Symptom Score from baseline.

Results

Combination therapy resulted in significantly greater improvements in symptoms vs dutasteride from month 3 and tamsulosin from month 9, and in benign prostatic hyperplasia related health status from months 3 and 12, respectively. There was a significantly greater improvement from baseline in peak urinary flow for combination therapy vs dutasteride and tamsulosin monotherapies from month 6. There was a significant increase in drug related adverse events with combination therapy vs monotherapies, although most did not result in the cessation of therapy.

Conclusions

In men with moderate to severe lower urinary tract symptoms and prostate enlargement (30 cc or greater) combination therapy provides a significantly greater degree of benefit than tamsulosin or dutasteride monotherapy.

Prostate Cancer Symptoms, Causes, Treatment - What are prostate cancer symptoms and signs on MedicineNet

Prostate Cancer Symptoms, Causes, Treatment - What are prostate cancer symptoms and signs on MedicineNet

What are prostate cancer symptoms and signs?

In the early stages, prostate cancer often causes no symptoms for many years. As a matter of fact, these cancers frequently are first detected by an abnormality on a blood test (the PSA, discussed below) or as a hard nodule (lump) in the prostate gland. Occasionally, the doctor may first feel a hard nodule during a routine digital (done with the finger) rectal examination. The prostate gland is located immediately in front of the rectum.

Rarely, in more advanced cases, the cancer may enlarge and press on the urethra. As a result, the flow of urine diminishes and urination becomes more difficult. Patients may also experience burning with urination or blood in the urine. As the tumor continues to grow, it can completely block the flow of urine, resulting in a painfully obstructed and enlarged urinary bladder. These symptoms by themselves, however, do not confirm the presence of prostate cancer. Most of these symptoms can occur in men with non-cancerous (benign) enlargement of the prostate (the most common form of prostate enlargement). However, the occurrence of these symptoms should prompt an evaluation by the doctor to rule out cancer and provide appropriate treatment.

Furthermore, in the later stages, prostate cancer can spread locally into the surrounding tissue or the nearby lymph nodes, called the pelvic nodes. The cancer then can spread even farther (metastasize) to other areas of the body. Symptoms of metastatic disease include fatigue, malaise, and weight loss. The doctor during a rectal examination can sometimes detect local spread into the surrounding tissues. That is, the physician can feel a hard, fixed (not moveable) tumor extending from and beyond the gland. Prostate cancer usually metastasizes first to the lower spine or the pelvic bones (the bones connecting the lower spine to the hips), thereby causing back or pelvic pain. The cancer can then spread to the liver and lungs. Metastases (areas to which the cancer has spread) to the liver can cause pain in the abdomen and jaundice(yellow color of the skin) in rare instances. Metastases to the lungs can cause chest pain and coughing.

• « Previous

A Brief Introduction To Prostate Nodules

A Brief Introduction To Prostate Nodules

A prostate nodule is any growth on the prostate which can be felt upon a digital rectal examination. Characterized as hard, soft, smooth or gritty, prostate nodules or the thickening in some portions of the prostate often develop as men grow older.
The evaluation for a prostate nodule may be included in the evaluation for prostitis or a possible infection. As a rule, all prostate nodules found require further evaluation to rule out the possibility of cancer, which may come without any other symptom.
Benign Prostate Nodules
A nodule does not automatically mean that cancer is present. Hard, rocky nodules may indicate calcification or a case of benign prostatic hyperplasia, where the epithelial and prostaticstromal cells multiply and grow large enough to form large nodules around the periurethral region of the prostate. Surgical removal is often necessary if the nodule has grown large enough to block the urethral canal and cause problems with urination. Sometimes, after a PSA test has shown borderline or elevated levels and there is presence of an infection, the doctor may initially put the patient in antibiotics for 2 to 4 weeks, after which the tests are repeated. If all tests are normal within this time, cancer can be ruled out, although a repeat exam is needed in 3 to 6 months.
Cancerous Prostate Nodules
About 50% of prostate nodules are malignant. Although a digital rectal examination cannot determine whether a nodule is cancerous or not, a biopsy can. A biopsy often follows when the doctor finds abnormal results from aProstate Specific Antigen test. Once the biopsy has revealed cancer, important variables which are then taken into consideration will include grading and staging. Grading of the cancerous prostate nodule makes use of theGleason score, which determines the degree of abnormality of the prostate cells from 2 (least aggressive) to 10 (most aggressive).
Staging, on the other hand is done on the basis of the DRE. A cancerous nodule is staged as follows:
T1c (PSA detected)
T2a (small prostate nodule)
T2b (larger prostate nodule)
T3 (very large prostate nodule with probable spread outside of the prostate)
T4 (prostate cancer spreading into adjacent organ such as the bladder)
Prevention And Treatment Of Prostate Nodules
There is no known cause why the prostate tends to enlarge as men get older, and why some men found to have prostate nodules develop prostate cancer and some don’t. Experts think genes and diet may play a role. Good nutrition may contribute to overall prostate health. Men who eat fruits and vegetables, foods that naturally contain antioxidants like lycopene and minerals like selenium lowered their risk for the disease significantly.
For men in their forties or older, an annual DRE may be necessary, especially for high-risk individuals. In some cases, whether the nodule is benign or malignant, surgical excision or complete removal of the nodule may become necessary.

Acute urinary retention secondary to carcinoma of the prostate. Is initial channel TURP beneficial?

Acute urinary retention secondary to carcinoma of the prostate. Is initial channel TURP beneficial?

What is Uroflowmetry?

What is Uroflowmetry?

Normal Values

Normal values vary depending on age and sex:

• Age: 4 to 7
  • The average flow rate for both males and females is 10 mL/sec.
• Age: 8 to 13
  • The average flow rate for males is 12 mL/sec.
  • The average flow rate for females is 15 mL/sec.
• Age: 14 to 45
  • The average flow rate for males is 21 mL/sec.
  • The average flow rate for females is 18 mL/sec.
• Age: 46 to 65
  • The average flow rate for males is 12 mL/sec.
  • The average flow rate for females is 15 mL/sec.
• Age: 66 to 80
  • The average flow rate for males is 9 mL/sec.
  • The average flow rate for females is 10 mL/sec.

What abnormal results mean

Results must be understood as they relate to the patient’s complaints and physical exam. A result that may need treatment in one patient may require no treatment in another patient.

Several circular muscles normally regulate urine flow, and if any of these muscles becomes weak or stop working, an increase in urine flow or urinary incontinence may result.

If there is a bladder outlet obstruction or if the bladder muscle is weak, a decrease in urine flow may result.

Any abnormal results should be discussed with you and explained by your health care provider.

Natural methods to treat an enlarged prostate

Natural methods to treat an enlarged prostate

With prostate problems affecting roughly 12% of men, chances are you, or someone you care about, will eventually have to deal with this problem.

The prostate is a gland about the size of a walnut, which sits just below the bladder in men and is an integral part of the male reproductive system. The prostate goes through 2 main periods of growth: the first period of groth occurs early in puberty, when the prostate doubles in size.

At about the age of 25, the prostate begins to grow again. This second phase of growth often results in what constitutes an enlarged prostate. As the prostate becomes larger, the layer of tissue surrounding it stops it from expanding, causing the prostate to press against the urethra.

While the studies do not all concur, it is generally believed that most men over the age of 45 experience some amount of prostate enlargement, but may live free of symptoms. This prostate enlargement is usually harmless, but it often causes problems urinating later on in life.

By age 60, it is believed that over 80% of all men experience some sort of problem with urinating due to prostate enlargement.

Prostate enlargement is not a malignant condition, but it does put pressure on the urethra and can create a number of urinary problems such as frequent urination, urinary urgency, the need to get up at night to urinate, difficulty starting, a reduction to the force of the urine stream, terminal dribbling, incomplete emptying of the bladder and even the inability to urinate at all.

If left unchecked, benign prostate enlargement can cause serious health problems over time, including urinary tract infections, kidney or bladder damage, bladder stones, incontinence. It is important to take care of your prostate as you would any other organ and address any prostate problems you may be having.

"Enlarged prostate", the medical term for which is BPH - short for Benign Prostatic Hypertrophy - has historically been treated surgically - by removing all or part of the prostate. While this will result in most people experiencing a relief of their symptoms, it may also leave them impotent. For men who want to maintain their vitality, surgery should only be used as a last resort.

Saw Palmetto for an enlarged prostate

Drugs are now commonly prescribed first, one of the more popular being "Proscar", manufactured by the Merck company. Proscar is actually a somewhat dangerous substitute for a classic herb, as a great number of pharmaceutical drugs are. The herbal remedy pirated in this case is the saw palmetto berry.

For men who suffer from prostate enlargement, saw palmetto is the place to start. Saw palmetto has a long history of diminishing inflammation and enlargement of the prostate as well as inhibiting the hormones which causes prostate enlargement.

Saw palmetto is a shrub which grows in Georgia and Florida along the ocean. Saw palmetto causes no side effects at the recommended dosage. This is in sharp contrast with the drug Proscar. Proscar has many serious side effects, which are listed on the package insert, published in advertisements for the drug, and they are also listed in the Physician's Desk Reference (PDR).

In my opinion, the lowest price for high quality saw palmetto can be found here. I also like Puritan Pride's special promotions on saw palmetto.

Another herb called "Pygeum africanum", comes from an African tree and has also been shown in research to reduce enlargement of the prostate as well as inflammation.

You can find the herb Pygeum in its purest form here. This particular online merchant is not cheap, but they do have the highest quality herbs and spices anywhere on the internet. A more affordable source of Pygeum is Puritan's Pride.

Zinc for a healthy prostate

Zinc is considered one of the most essential trace elements, and it is believed to play a critical role in cell growth and differentiation, in regulating normal cell death, as well as in in building the immune response. Scientists tell us that there exist more biological roles for zinc than for all the other trace elements put together.

Zinc is both helpful with enlarged prostates and with inflamed prostates. Studies (1) have shown that zinc deficiency results in prostate enlargement. Infection and other stress results in lower blood serum zinc levels in general and in particular lower prostate levels. In prostatitis - infection of the prostate - zinc levels are only 1/10 of those in a normal prostate (2).

A large percentage of men do not get even the low U.S. RDA of 15 milligrams of zinc per day from their diet, and this may explain a lot.

A daily zinc supplement totaling 50 to 100 milligrams is frequently recommended to help shrink an enlarged prostate. As with any supplement however, zinc should be taken in moderation and the intake of supplements should complement what we are getting from natural healing foods in our diet.

I believe the best price on the internet for high quality zinc supplements to be here.

Exercises for a healthy prostate

Kegel exercises are useful in improving blood circulation to these tissues. Kegel exercises are performed by tightening all the muscles around the scrotum and anus. Repeat this tightening of the muscles 10 times. Try doing this “invisible” exercise 4-5 times daily, while driving, reading, etc.

Finally, it would appear that making tomatoes part of your diet is a good idea if you are concerned about the health of your prostate. Harvard study (3) of 47,000 men in 2003 found that men who ate 10 servings per week of tomatos cut their risk of developing aggressive prostate cancer by 50%. Researchers believe this decrease in cancer risk is due to the lycopene in the tomatoes - the pigment that gives tomatoes their red color.

We now know that lycopene is the most powerful carotene discovered yet, with 10 times moreantioxidant power than beta carotene.

Natural methods to treat an enlarged prostate

Natural methods to treat an enlarged prostate

Healing Diet, Detoxification Diet

Healing Diet, Detoxification Diet

Misstaging and misgrading: it's a problem

Misstaging and misgrading: it's a problem - Wellsphere Misstaging and misgrading: it's a problem - Wellsphere Currently available treatment options for the early (localized) stages of prostate cancer are potentially curative. However, patients with locally advanced disease are less likely to be cured by today’s treatments. The Problem of MisstagingIf your doctor finds that you have prostate cancer after carrying out a biopsy, the next question that he has to try to answer is, “What is the clinical stage of this cancer?” Unfortunately, this can be a hard question to answer in any particular case except that of clearly metastatic disease, where tumors have spread to parts of the body far from the prostate, and can be seen on a bone scan.Hank had a DRE and a PSA a while ago, and went on to have a biopsy. This is what Hank’s urologist knew after he’d got the biopsy results:He thought he could feel a small, suspicious nodule on the left lobe of Hank’s prostate when he did the DRE.Hank’s PSA was 8.9 ng/mL.The biopsy confirmed prostate cancer only in one small nodule in the left lobe of Hank’s prostate, close to the capsule (or wall) of the prostate.The biopsy report on the tumor gave a Gleason score of 4 + 3 = 7.On a classical basis, Hank has all the indications of clinical stage T2aN0M0 disease — locally confined prostate cancer in one lobe of the prostate detectable by DRE.Hank was just 49 years old at the time, and he opted for minimally invasive surgery. Unfortunately, after the procedure, Hank’s doctor had to tell him that his prostate cancer was in fact locally advanced. Despite the fact that there was no good reason to expect this, prostate cancer cells were found in Hank’s seminal vesicles by the pathologist. His pathological stage is actually T3bNxM0. Why the Nx? Because there was no good reason for anyone to think about doing a lymph node dissection at the time of the surgery, so no one knows whether Hank’s regional lymph nodes are positive or negative.About 18 months later, despite an excellent initial response to surgical treatment, Hank’s PSA starts to rise again. Hank has recurrent prostate cancer.Of course, Hank’s doctor knew that this outcome was possible, and he had told Hank that this was a possibility when they discussed treatment options together. He also told him that this was a not a strong probability. That doesn’t make anyone any happier. But it happens … and it happens more often than anyone would like.There is a strong and very natural desire on the part of patients and their physicians to want to believe (and thus to act as though) individual cases of apparently localized prostate cancer are going to curable — particularly those cases of prostate cancer which look as though they have a good chance of being curable — like Hank’s! After all, who wants to throw in the towel on the grounds that the worst case is bound to happen?However, it is relatively easy to mis-estimate the initial clinical stage of an individual patient’s cancer. Most often, when the stage is wrong, the cancer is subsequently found to be of higher stage than the doctors first thought. In Hank’s case, because he insisted on having aProstaScint test when his PSA started to rise again, the cancer was actually discovered to be stage T3bNoM1a, with a tiny degree of extension of the cancer into one of Hank’s seminal vesicles and micrometastasis to a non-regional lymph node.There is, in fact, no reasonable way that anyone could have known Hank’s precise stage at the time of diagnosis. Even if his doctor had given him the ProstaScint test prior to surgery, the degree of accuracy of this test is not sufficient to confirm distant metastasis in one of the non-regional lymph nodes, and (given the position of the apparently small tumor clearly confined in the prostate), there was also no apparent need to biopsy the seminal vesicles.The Problem of MisgradingThe other thing that happens in somewhere between 20 and 40 percent of cases is the problem of misgrading, where the initial Gleason grades (and therefore the Gleason score ) assigned by the pathologist at the time of biopsy are later found to be higher (or lower) than the grade of the tumor when the actual prostate is surgically removed. Data from over 1,350 patients published by one experienced academic center on the correlation between pre-surgical (biopsy-based) staging and post-surgical staging (based on the entire prostate) clearly demonstrated that the accuracy of pre-surgical staging at that institution improved significantly from 1992-96 (when there was 58 percent correlation) to 2002-06 (when there was 75 percent correlation). However, that still means that there is a lack of correlation among 25 percent of recent patients.In this situation, of course, the pathologist can only grade what he or she gets to see. If the biopsy needle doesn’t “hit” a piece of tumor with the highest grade at the time of the biopsy, then no one could have known that there actually was higher grade tumor until the pathologist was able to look at the entire prostate after surgery.As in the case of mis-staging, the published data also clearly show that undergrading at biopsy is far more common than overgrading. Of the 1,363 patients in the study referenced, 361 (26 percent) were undergraded at biopsy and just 65 (5 percent) were overgraded.The point of this discussion is only, once again, to advise you that there are no certainties in the treatment of prostate cancer. Despite everyone’s best attempts, there will be many occasions when the apparent best is not good enough. Until we are able to develop absolutely definitive tests that can tell any individual patient whether there is any cancer outside his prostate, this situation will continue to be the case. Link: http://www.wellsphere.com/cancer-article/misstaging-and-misgrading-it-s-a-problem/363290

MRI, CT, and other imaging tests in diagnosis of prostate cancer « THE "NEW" PROSTATE CANCER INFOLINK

MRI, CT, and other imaging tests in diagnosis of prostate cancer « THE "NEW" PROSTATE CANCER INFOLINK

MRI, CT, and other imaging tests in diagnosis of prostate cancer

Although bone scans are the primary and most important imaging test used in the diagnosis of prostate cancer, several other imaging tests also have significant — if slightly less central — roles. If you are one of the people who needs one of these tests, it will help you to have some idea what is going on.

When Is an MRI Appropriate?

Magnetic resonance imaging or MRI uses strong magnetic fields instead of x-rays to produce images of parts of the body. MRI scans can be very helpful in looking at prostate cancer. By producing a very clear picture of the prostate gland, an MRI can show whether the cancer has spread outside the gland into the seminal vesicles or bladder. Unfortunately the cost of carrying out MRI examinations on every patient whomight have prostate cancer extending beyond the prostate capsule would be enormous. Thus, from a diagnostic point of view, the important question is, “When is an MRI really appropriate?”

It is hard to give a precise answer to this question, but some form of MRI may be most apppropriate in a patient at clear risk for T3NxM0 or T4NxM0 disease. Such patients are unlikely to be able to receive surgery alone with curative intent. So, in order to determine whether treatment with curative intent is even possible, one needs to have the clearest possible understanding of the extent of the cancer before deciding how to proceed.

MRI can be carried out either using traditional “whole body” MRI scanning or through the use of “endorectal coil” MRI. However, the optimal MRI technique for the staging of prostate cancer has not been established. At the present time, endorectal MRI appears more accurate than body-coil MRI in the local staging of the primary tumor. However, this is an area of rapid evolution, and currently experimental imaging techniques may become standard within the next few years, making highly accurate visualization of cancer in and around the prostate possible for clinical staging purposes (and for the planning of surgery, radiotherapy, and other treatment techniques).

The Role of CT Scans

CT or computerized tomography is a computer-controlled x-ray procedure that produces detailed cross-sectional images of the body using hundreds of x-ray-like images. This test can help to tell whether prostate cancer has spread beyond the prostate to other organs. However, CT scans are much better at identifying skeletal structures than soft tissue structures.

The role of CT or CAT scanning in the diagnosis of prostate cancer is really very limited today because almost anything one can do with a CT scan can be done just as well or better with an MRI scan. The one place where CT scans appear to have a small advantage is in the early identification of soft tissue metastases (as opposed to bone metastases). However, the need for this type of information outside clinical trials is relatively limited.

Color Döppler Ultrasound

A select group of subspecialists have been strong advocates for the use of color Döppler ultrasound imaging in the diagnosis of prostate cancer. They have claimed that the use of this technique permits much greater accuracy in the identification of prostate cancer, and also in carrying out appropriate prostate biopsies.

It is hard to know whether such claims are really accurate because of the limited use of this equipment and the lack of controlled trials. However, a study published in 2007in the Journal of Urology, and involving 690 men, appears to support the value of color Döppler ultrasound compared to standard ultrasound-guided biopsy as a highly accurate method which is helpful in the pretreatment staging and grading of prostate cancer.

The ProstaScint Imaging Technique

The ProstaScint imaging technique first became available in the mid 1990s as a highly promising technique that appeared to be able to identify prostate cancer that had escaped from the prostate and into the pelvic lymph nodes and other surrounding tissues. As such, this test gave hope that it would be possible to better identify those patients in whom surgery alone as a treatment carried out with curative intent would not be feasible.

Unfortunately, the ProstaScint test has never been able to achieve its initial promise, despite every effort by the manufacturer to improve technical aspects of the means to image the indium-111-labeled monoclonal antibody on which the test is based.

When this test works well, using the current “fusion imaging” process, it can produce remarkable results, but the repeatability of these results and the effort needed to gain the necessary image quality appear to be problematic for the majority of centers.

Having said that, a patient who is at high risk for micrometastatic disease may wish to seek out a center with the technical ability to use the ProstaScint fusion imaging process well — if his insurer will cover the use of the process. There seems to be little doubt that for some patients this technique has provided great assistance in identifying the precise location of potentially troublesome tumors.