HJAR Jul/Aug 2022

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2022 49 R. Jonathan Henderson, MD Arkansas Urology TheAxumin was the first effective way for us to seemetastatic prostate cancer. It is able to find these deposits anywhere in the body. The next is a PET called PSMA, which uses an antibody that binds to prostate cancer specifically. Attached to that antibody is the radiotracer, which thenmakes the image on the PET camera. This test is about two times as sensitive asAxumin. This means it is able to find cancer spots half the size, so we can find the cancer earlier. This is where technol- ogy has really shone. Antibodies are able to be attached to a number of different mol- ecules. A different radioactive molecule, lu- tetium, when attached to the PSMAantibody, can deliver a payload of deadly radiation di- rectly to the cancer cell to which it binds. This radiation is deadly to that cell only, not the other tissue in the body. So, we now have a way of finding cancer with a PSMAPET and then, using the exact same locating device, deliver a killing blow anywhere in the body. This is truly a world-shaking breakthrough, and it is opening a new field for us termed “theragnostics.”Theragnostics uses the same mechanism to both diagnose and treat a dis- ease, and it’s a hot new field in medicine. These new diagnostic and therapeutic mo- dalities are very exciting for those of us who treat patients. We have sat by for decades and watched helplessly simply because the tech- nology was not yet invented. But the most excitement is reserved for the patients.Thank God for science, technology, and the health- care teams who use it! n R.Jonathan Henderson, MD, obtained a Bachelor of Science Degree at LSU in Baton Rouge,Louisiana, in microbiology.After receiving amedical degree at LSU Medical Center in Shreveport, he completed an in- ternship and residency in urology at LSUMCHospital. Henderson spent the next six years in practice in Alabama. During that time, he served as a repre- sentative ofAlabama to the Southeastern Section of the American Urology Association. He also served as an assistant clinical professor of urology at the University of Alabama. Henderson is certified by the American Board of Urology.He focuses his practice primarily on robotic surgeries and the treatment of prostate cancer. He is also actively involved in the research department at Regional Urology. He is a member of the Ameri- can Urologic Association, Shreveport Medical Soci- ety, Louisiana State Medical Society, the Society of Laparoscopic Surgeons,and theAlpha OmegaAlpha Medical Honor Society. He has been on the LUGPA board of directors since 2011 and is currently serv- ing as president. were unable to find exactly where the cancer was and were unable to do anything about it once found. That has all changed. There are multiple new treatments available, and while discussing them is exciting, that is for an- other time. To be able to treat cancer, we have to be able to find it. And the breakthroughs in just howwe do this are what I am excited to share here. Prostate cancer that has spread is termed metastatic prostate cancer. Prostate cancer usually follows a pattern of spread — first to lymph nodes, then to bones, and finally to organs. When we are looking to find the me- tastasis, we first look at lymph nodes. Tradi- tional imaging such as CT has been of limited use. The advent of PET (positron emission tomography) has triggered an avalanche of new options. The first is a test calledAxumin. This uses amolecule that resembles an amino acid that only prostate cancer absorbs. This molecule is attached to another molecule called a tracer, which is a radioactive mol- ecule that can be seen with a special camera. Apatient is given an IV injection of the tracer, and it concentrates in prostate cancer. This can then be seen with the PET camera. “While many men opt to forgo screening because a third of cases may never need to be treated, the problem is that until we know there is cancer in the first place, it is impossible to determine whether or not it requires treatment or can simply be observed. With newer blood tests and genomic testing available, we can better work through this decision with fewer unnecessary tests and treatments.”