Screening tests for breast and prostate cancers are important for appropriate treatment
According to data from the National Cancer Institute (INCA), breast cancer and prostate cancer are the second most common among women and men, respectively. They are second only to non-melanoma skin cancer (skin cancer). These data contribute annually to Pink October and Blue November, which are used to disseminate information and raise awareness about diseases.
With the prior recognition of the disease, it is possible to contain the advance of cancer cells and prevent them from contaminating other regions of the body, forming the so-called metastases, a more advanced stage of the disease. cancer. Therefore, nuclear medicine proves to be an important diagnostic and therapeutic tool of precision and agility for these types of cancer.
Tests to diagnose breast and prostate cancer
Scintigraphy
Scintigraphy is one of the main tests used to detect breast cancer in women. bone structures. “Breast cancer is often a tumor that likes to migrate to bone, and nuclear medicine has been working on this screening for many years. The first test available for this diagnosis is a bone scan, which can assess the entire skeleton from a single small amount of radioactive material injected into the patient, “says Dr. Adelina Sanches, director of the Brazilian Society of Nuclear Medicine (SBMN).
According to the specialist, this type of test is effective and inexpensive for detecting the disease. “It is a safe and inexpensive method, covered by the SUS [Sistema Único de Saúde] and it is widely used. Its performance rate, or injury detection potential, is around 85%, ”adds Dr Adelina Sanches.
radiopharmaceutical
A radiopharmaceutical (medicinal with radioactive atoms), which began development in 2016 and was approved by Anvisa in October 2021, stands out for being the first specific breast cancer marketed in Brazil. “This is Radiofes®, a radioactive tracer for estrogen receptors, a situation present in about 80% of neoplasms [formação de massa anormal de tecido] breasts “, explains Dr. Adelina Sanches.
According to her, this type of drug is very beneficial for the patient. “Having a specific tracer has many advantages, because, if the patient has breast cancer and another lung cancer, for example, it allows us to identify if the metastasis is due to breast neoplasm or the lung. This helps a lot in starting therapies, often saving the woman also from new biopsies and new invasive procedures “, says the specialist.
The director of SBMN, on the other hand, underlines that Radiofes® plays an important role in solving the so-called “clinical dilemmas”: “Although it is not the ideal tool for primary diagnosis, it has an important role in resolving various situations that can lead to dilemmas or clinical uncertainty scenarios, such as defining a therapeutic approach in difficult cases, evaluating the efficacy of treatments and investigating the expression of receptors in the tumor and in metastases (which can manifest heterogeneously). efficacy in the treatment of patientsand the consequent improvement in their quality of life, without forgetting the savings in terms of costs with medical procedures, “he explains.
Positron Emission Tomography
Other nuclear medicine tests that demonstrate excellent performance for breast and prostate cancers are the well-established positron emission tomography (PET / CT) – with FDG (glucose analogue) and with PSMA (prostate specific membrane antigen) .
For very advanced tumors it is possible to evaluate the patient’s entire body, demonstrating whether he has lung, liver, other organ or skeleton disease. These are tests that work better than bone scans.
“For the case of breast cancer, we have PET / CT with FDG, which is a more traditional procedure, which uses radioactive labeled glucose. The role of FDG PET in breast cancer is gaining increasing recognition. Indeed, studies are starting to bet on reducing the therapeutic burden in patients who show excellent signs of test response when undergoing some treatment “, Dr. Adelina Sanches.
Again according to the specialist, “for prostate cancer new radiopharmaceuticals are being produced in Brazil, in line with what is happening in the rest of the world, both through institutes linked to the CNEN (National Commission for Nuclear Energy) and in the private sector”.
Marina Bicalho Silveira, pharmacist at the Nuclear Technology Development Center (CDTN), stresses that “new radiopharmaceuticals are being developed at CDTN, such as PSMA1007 18 F, intended for the diagnosis of prostate cancer. also be available on the public network “.
Use of radiopharmaceuticals and nuclear medicine in Brazil
For Marina Bicalho Silveira there is still a lot to improve in the country in this sector. “We still have a long way to go, as it takes time and a lot of study to include a new technology in SUS. However, having the radiopharmaceutical available is the first step,” she says.
According to her, the marketing of this made in Brazil started a year after its approval in the United States. “This is a big step forward for Brazilian radiopharmacy and nuclear medicine. Now we must devote ourselves to clinical trials and effectively help make PET with fluorestradiol (18F) available to more people through SUS.”
by Newton Silva
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Source: Terra
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