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X marks the spot

Canadian researcher using scans to map more effective radiation therapy

Radiation is usually the first option doctors offer patients when their prostate cancer comes back after surgery. Doctors target the area where the prostate used to be, based on the predication that this is where the cancer has most likely recurred. The reality is we aren’t always able to tell exactly where the cancer is. This means that the radiation can be targeting healthy cells, and the patient will experience side effects.

Dr. Cynthia Menard, of Hôpital Notre-Dame in Montreal, is determined to change that. She is working on a tool for doctors that will make radiation treatment more effective and less toxic.

Transforming scans into a map

A newer and more sensitive type of scan, called PSMA PET imaging, is helping doctors capture prostate cancer progression. Dr. Menard’s team is using thousands of these images from different patients to construct a model, or map, that will help doctors predict where a particular patient’s cancer is likely to have returned. Then, they can target the radiation to that area. 

An example of a PSMA PET scan Dr. Menard is using in her research

“My ultimate hope is that we’ll provide radiation oncologists with a tool that will allow them to paint the dose where it’s needed most in a patient, when there’s really no other information about where the disease lies,” she says.
“In that way, we hope to improve cure rates and improve toxicity of radiation.”

Dr. Menard sees the end product as a website where doctors can upload their patient’s image, type in their PSA number, Gleason score and other disease characteristics, and then download a map that is tailored to their patient.

"Then, you could import that map into your treatment planning system to be able to give a prescription dose of radiation to the areas that are deemed at highest risk of recurrence.”

Minimizing anxiety

Fear of cancer returning can be difficult for families. Dr. Menard hopes that this research will help alleviate that stress.

“I hope that anybody who goes through surgery and fears a failure will be reassured that if it does fail, the follow-up radiation will be more tailored to their particular situation.”

“So the second round of treatment is more likely to be successful,” she says.

Summing up her hopes, she says: “I think it will be a tool that I would have loved to have for a long time now, that would have really helped me to treat patients.”

A personal crusade


For Dr. Menard, it’s personal.

“My grandfather was 63 years old when he died of prostate cancer,” she says. “I was young, about 4. And it had an impact, as you would imagine.”

From an early age she wanted to be an oncologist. While attending medical school in Calgary, she met other investigators and clinicians working in prostate cancer, and it was a natural fit for her to pursue work in the space.


“There’s just so much to be done. It’s a disease that’s been unrelenting for so long, and there seems to be no end of opportunity to make things better for these patients.”

This project is proudly funded by Movember and awarded by Prostate Cancer Canada as part of the Discovery Grant program. In 2019, this was one of ten projects awarded through the program to save and improve more lives of those affected by prostate cancer.
Your donation helps protect men and their families from prostate cancer.
You'll be supporting the most promising research projects, and providing men with care and support when they need it most. 
Posted: 2019-09-17 8:00:00 AM


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