Already more than 600 men have been able to benefit from a Quebec innovation in the field of nuclear medicine providing a larger number of patients with a much more precise diagnosis of prostate cancer.
• Read also: Prostate cancer: a very rare disease in young people
• Read also: Prostate cancer survivor: “Go get tested, guys,” implores Régis Labeaume
• Read also: Prostate cancer particularly aggressive in young people
For the past year, the CHUS Research Center (CRCHUS) has been offering positron emission tomography (PET) imaging for the diagnosis of prostate cancer. An approach as recent as it is effective.
Imaging showing bone, lymph node and lung metastases. In the center of the cursor, a bone metastasis in a lumbar vertebra.
Photo provided by the CIUSSS de l’Estrie-CHUS
An imaging agent, the radiotracer 68Ga-PSMA-617, is injected into the patient. This agent was designed specifically to attach to prostate cancer cells. The tomograph examination then makes it possible to precisely visualize the location of the cancer cells.
“Each cancer has its characteristics. For that of the prostate, we look for a characteristic called PSMA. The agent will interrogate all the cells of the body for an hour,” explains Dr.r Éric Turcotte, nuclear scientist and professor-researcher at CRCHUS and the University of Sherbrooke.
Photo provided by the CIUSSS de l’Estrie-CHUS
Learn more, quickly
The approach allows us to give the most suitable treatment with the highest success rate.
“We do blood tests, we know there is prostate cancer. Sometimes we assumed the presence of cancer in one place. We were playing “Where’s Waldo?” all day. There, we no longer assume, we confirm where the lesion is. It remains for the oncologist to decide how to tackle it,” adds Dr.r Turcotte.
“We are no longer going to remove a prostate, with the problems that that can cause, and find ourselves three or four years later with a metastasis that we had not seen at the start,” he believes.
Accessibility
However, a large infrastructure is necessary to produce the radiotracer. This is where Quebec research comes in.
“My team has developed an innovative technology to produce the imaging agent in large quantities and offer it to more patients,” explains Brigitte Guérin, professor-researcher at the University of Sherbrooke and researcher at CRCHUS.
“With current technology, we can only produce enough agent for two patients. With ours, we can examine 15 patients,” she continues.
Brigitte Guérin, professor-researcher at CRCHUS and the University of Sherbrooke, in her laboratory.
Photo provided by the CIUSSS de l’Estrie-CHUS
An important issue to benefit from the advantages of new diagnostic technology.
“It is estimated that one in eight men will have prostate cancer,” explains Dr.r Turcotte. The imaging test should not be a lottery. The work over the past three years has been to make the treatment accessible. At 15 exams per half-day and sometimes two half-days per week, it corresponds to the needs of our population in Estrie and we have a surplus that we offer to patients in the rest of Quebec.”
“Our technology is patented and licensed. We are working to make it accessible everywhere internationally. We work a lot with the Atomic Energy Agency on the needs of patients,” says M.me Guérin.
Heal the same way
The CRCHUS took the next step using the same approach to treatment.
“In the new therapies that are coming, less invasive and more effective, the diagnostic imaging agent is replaced by a therapeutic radioisotope. He will surrender [sur la lésion] as the diagnostic agent and will kill the cancer cells it sticks to. We go with a radar to start and then we send the torpedoes. These are emerging treatments in Canada that can make a difference in the case of advanced cancers,” believes M.me Guérin.
Production of imaging agent
Photo provided by the CIUSSS de l’Estrie-CHUS
“An impressive factor is the tolerability of these treatments and their ease,” insists Mr. Turcotte. The injection lasts one minute. I see the patient again six weeks later. It doesn’t lose hair, doesn’t really have any side effects. They tell me with a big smile how easy it is compared to chemotherapy.”
“In a few years, what we do today will become a standard,” is convinced the Dr Turcotte.
Production of imaging agent
Photo provided by the CIUSSS de l’Estrie-CHUS
Money
But there is a bone that could slow down the application of therapy.
“The Quebec government has not yet ruled on reimbursement for this new treatment. This is a big issue. I can tell you that it is highly effective. With each treatment, 50% of the disease disappears. Currently, we recruit our patients in our research projects, sometimes the foundations also agree to pay, the situation is not comfortable,” admits Dr.r Turcotte.
But the day the treatment is reimbursed, “the imaging test will have to be ready [dans les hôpitaux]. In Sherbrooke, we are,” he assures.
Other cancers
The approach taken by the two researchers will not be limited to prostate cancer.
“This is a new range of treatment that we are developing. There are starting to be new molecules that will target breast cancer and brain cancer. It’s booming,” says Éric Turcotte.
Dr. Éric Turcotte, nuclear scientist and professor-researcher at CRCHUS and the University of Sherbrooke, in his office, where he analyzes the images produced using the positron emission tomograph.
Photo provided by the CIUSSS de l’Estrie-CHUS
“We are doing research on breast cancer. And PSMA also reacts with other types of cancer. We have steps underway to see the relevance of using the same agent with other types of cancer,” concludes Brigitte Guérin.