A trial of a PSMA scan for prostate cancer (PANORAMA)

Sometimes prostate cancer can spread to the lymph nodes or other parts of the body. It is important to know how far the cancer has spread to plan treatment.  At the moment it is very difficult to find out if the prostate cancer has spread to the lymph nodes in the pelvis. 

Sometimes the surgeon removes these nodes during surgery. But when they are examined under a microscope, they might not contain cancer cells. So doctors are looking at ways to avoid removing these nodes if it isn’t necessary.  

To do this they are using a PSMA PET-CT scan. This scan looks at the levels of a molecule called PSMA in the prostate cancer cells. PSMA stands for Prostate Specific Membrane Antigen. There are higher levels of PSMA in prostate cancer cells. 

It is usual to have a PSMA scan to look for prostate cancer that has spread beyond the pelvis. It is unclear whether this scan can also help your doctor to see if the nearby lymph nodes have cancer cells in them. So doctors are running this trial to find out more. 

The trial team look at the PSMA PET-CT scan results.  And after surgery a specialist doctor looks at whether you have cancer cells in the lymph nodes. They then compare this information. 

The main aims of the trial are to find out:

• how accurate the PSMA scan is at picking up if the cancer has spread to the nearby lymph nodes 
• if high levels of PSMA in the prostate gland means there are more likely to be cancer cells in the pelvic lymph nodes