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Medically Approved by Dr Aqua Asif (Jun 18th 2025)
Written by Neil Patel
If you’ve ever wondered what a PSMA PET scan is for prostate cancer, you’re not alone. This advanced scan can find cancer cells in your body, even when they’re small or hidden. It’s an important tool that helps doctors plan the best treatment for you.
For men with prostate cancer or those worried about it coming back, this scan gives doctors detailed information. It helps them make better decisions about your treatment and care. At The Focal Therapy Clinic, PSMA PET scanning is part of how we provide safe, effective treatment that protects your quality of life.
Understanding PSMA and its role in prostate cancer
Before explaining how a PSMA PET scan works, it helps to know what PSMA is and why it makes this scan so effective at finding prostate cancer.
What is PSMA?
PSMA stands for prostate-specific membrane antigen, a protein found on the surface of prostate cells. Healthy prostate cells produce small amounts of it, but cancer cells usually make much more. This big difference makes PSMA a useful target for accurate cancer imaging.
Studies show this protein often increases as cancer becomes more aggressive. By finding where PSMA levels are highest, doctors can see where prostate cancer cells are most active. This is especially important for detecting cancer that may have spread beyond the prostate gland.
Why PSMA is important in cancer detection
Since PSMA appears mainly on prostate cancer cells, it lets doctors focus on areas that are likely to have cancer. The special tracer used in the scan sticks to these proteins and lights them up on the images. This makes it easier to spot even small areas of cancer.
Other scans can sometimes miss tiny spots of cancer, especially when PSA levels are low. But PSMA PET scans may detect cancer recurrence at PSA levels as low as 0.2 ng/mL. This can be especially helpful if you’re having early symptoms that might suggest cancer is returning.
How a PSMA PET scan works
The scan process is straightforward and well-tolerated by most patients. It involves a small injection followed by detailed imaging to look at your whole body.
What to expect during the scan
You’ll get a small injection of the PSMA tracer, usually in your arm. This tracer travels through your blood for about an hour, sticking to any prostate cancer cells it finds. While you wait, you’ll rest quietly so the tracer can settle properly.
Next, you’ll lie on a table that slides through the PET scanner to take detailed pictures. You’ll need to stay still for about 20-30 minutes to make sure the images are clear. The whole appointment usually takes about 2-3 hours from start to finish.
Tips to prepare:
- Wear metal-free clothing like jogging trousers or a plain T-shirt.
- Avoid jewellery, belts, glasses, or watches on the day.
- Let your team know if you feel anxious or claustrophobic, medication can be provided.
How the tracer targets prostate cancer cells
The tracer has two parts: one that finds PSMA proteins, and a tiny amount of radioactive material that shows up on the scan. Once injected, it travels through your blood and attaches to prostate cancer cells wherever they might be in your body.
The most common tracers are Gallium-68 PSMA or Fluorine-18 PSMA, both safe and effective. After the scan, your body naturally gets rid of the tracer through your urine over the next day. The radioactivity is very low and safe for you and your family.
How it compares to CT, MRI, and bone scans
CT and MRI scans mainly show what structures look like, but not always if cancer is active. Bone scans only see cancer that has reached the bones and can miss smaller areas. PSMA PET scans do both, showing structure and areas where cancer cells are active.
For instance, bone scans often only find disease when it’s already advanced. But PSMA PET scans can find small clusters of cancer even before other scans pick them up. When combined with MRI imaging, it offers the clearest view possible of cancer spread.
When Is a PSMA PET Scan used?
Doctors may recommend this scan at different points in your prostate cancer journey. It’s most helpful when the results will directly affect your treatment decisions.
For initial staging of prostate cancer
When prostate cancer is first found, doctors need to know if it’s still contained in the prostate or has spread elsewhere. PSMA PET scanning works best for men with high-risk disease – typically those with higher PSA levels, high Gleason scores, or more advanced disease.
For men who might be suitable for focal therapy treatment, the scan helps confirm whether the cancer is truly localised. If the scan shows cancer has spread, different treatments may be more appropriate.
Detecting cancer recurrence
A rising PSA level after treatment is often the first sign that cancer may have returned. Traditional scans often can’t find where the cancer is if PSA levels are still low. But PSMA PET scans can see signs of recurrent cancer earlier than most other tests.
This early detection means your doctors can spot and treat returning cancer sooner. The scan also shows whether cancer has come back near the original site or spread to other areas, which helps guide treatment choices. This extra detail helps when talking about different treatment options and next steps.
Planning or adjusting treatment
PSMA PET scans give doctors the information they need to plan the best treatment. If cancer is in small areas, treatments like HIFU or Nanoknife might be right for you. But if the cancer has spread more widely, other treatments may be more appropriate.
The scan can also show if PSMA therapy, a special radioligand treatment, is a good choice. This therapy only works if the tracer sticks to the cancer cells during the scan. If it doesn’t, your doctor may suggest other latest treatment approaches.
Benefits and limitations of PSMA PET scans
Like any medical test, PSMA PET scanning has both advantages and limitations that are important to understand.
Improved accuracy and detection
PSMA PET scans are known to be more sensitive and specific than older scans. They can pick up cancer when it’s small and hidden, in places other tests might miss. This helps you and your doctor make smarter decisions and avoid unnecessary treatments.
Studies suggest treatment plans may be changed in about 28% of cases after PSMA PET scanning. This better precision means fewer men may receive inappropriate treatment recommendations, while ensuring those who need treatment are identified quickly. This is particularly important considering your individual prostate risk.
Accessibility and cost
PSMA PET scans are becoming easier to find in the UK, but they’re not everywhere yet. Some NHS hospitals now offer them, but you might wait a while to get the test. At The Focal Therapy Clinic, we offer this scan as part of our advanced early screening for self-pay patients.
Costs can be different depending on your clinic and whether you have insurance. Some private health plans cover the scan if you have high-risk disease or if your cancer has come back. If you’re not sure if it’s covered, one of our consultants can help you find out.
Not suitable for all patients
This scan isn’t perfect and won’t find every type of prostate cancer. Some tumours don’t make much PSMA, so they can be missed on the scan and cause false negatives. Sometimes, it can also find things that look like cancer but aren’t, leading to false positives.
Possible side effects include:
- Soreness or swelling where the tracer was injected.
- Mild allergic reactions like itching or hives.
- Rare symptoms such as nausea or tiredness.
Is a PSMA PET scan right for you?
Whether a PSMA PET scan would help your specific situation depends on several factors including your cancer characteristics and current PSA levels.
Talking to your doctor
It’s a good idea to bring up the scan at your next doctor’s visit. The scan can be especially helpful if your Gleason score is high, your PSA is rising, or your treatment needs to be reviewed. Your doctor may also recommend it when considering focal therapy treatment options.
At The Focal Therapy Clinic, we use PSMA PET scans with other tools to offer the best possible care. We always review every case as a team to find the right approach for you. Asking about the scan is a simple way to open up new possibilities for treatment.
Insurance and availability
Some private insurance plans now cover PSMA PET scans, particularly if cancer has come back. Others may still treat it as a specialised or newer option. If you’re self-paying, we’ll work with you to keep the cost manageable.
Availability also depends on where you live and who your care provider is. Not every clinic has the right scanner or team to do the test. We’re proud to offer this scan at our clinic to support accurate diagnosis and latest treatment planning.
Questions to ask your doctor
When considering PSMA PET scanning, prepare questions to understand how results might affect your care:
Here are some questions to bring up with your doctor:
- Will the scan results change my treatment options?
- Is it the right time for a scan based on my PSA and other factors?
- What treatment approaches are available if cancer is found?
- Are there any special preparation steps for me?
These discussions help ensure any scan performed will give useful information that improves your care.
Conclusion
PSMA PET scans are a powerful tool that can transform prostate cancer care. By targeting a protein found on prostate cancer cells, these scans help doctors see where cancer is, and where it isn’t, leading to more precise treatment decisions. For men seeking focused, less invasive options, PSMA PET scans can be the key to a more personalised approach that protects quality of life.
FAQs
What is a PSMA PET scan for prostate cancer?
It’s a scan that uses a special tracer to locate prostate cancer cells throughout the body. The tracer sticks to a protein called PSMA, which is commonly found on prostate cancer cells. This makes it easier for doctors to see exactly where cancer is and plan treatment accordingly.
At what PSA level should a PSMA scan be done?
A PSMA PET scan can pick up cancer when PSA levels are very low, as low as 0.2–0.3 ng/mL. However, detection rates improve with higher PSA levels. Your doctor will decide if it’s right for you based on your situation and treatment history.
How accurate is a PSMA test for prostate cancer?
PSMA PET scans are highly accurate for finding prostate cancer in many parts of the body. Research indicates they may perform better than other types of scans. However, like all tests, they aren’t perfect and may sometimes miss certain tumours or show false positive results.
What is the difference between a PET scan and a PSMA PET scan?
A regular PET scan uses a tracer that shows general cell activity throughout the body. In contrast, a PSMA PET scan uses tracers that specifically target prostate cancer cells. This makes it much more specific and useful for prostate cancer detection and monitoring.
References
Wright GL Jr, et al. Expression of prostate-specific membrane antigen in normal, benign, and malignant prostate tissues. Urol Oncol. 1995;1(1):18-28.
Perera M, et al. Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer. Eur Urol. 2020;77(4):403-417.
Fendler WP, et al. ⁶⁸Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging. Eur J Nucl Med Mol Imaging. 2017;44(6):1014-1024.
Hofman MS, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer (proPSMA). Lancet. 2020;395(10231):1208-1216.
Tilki D, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer. Part II-2024 Update: Treatment of Relapsing and Metastatic Prostate Cancer. Eur Urol. 2024;86(2):164-182.
Fendler WP, et al. Assessment of ⁶⁸Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer. JAMA Oncol. 2019;5(6):856-863.
Hope TA, et al. Metaanalysis of ⁶⁸Ga-PSMA-11 PET Accuracy for Prostate Cancer Detection. J Nucl Med. 2019;60(6):786-793.
Rowe SP, et al. PSMA-Based PET/CT Is Superior to Conventional Imaging for Lesion Detection in Metastatic Prostate Cancer. Mol Imaging Biol. 2016;18(3):411-419.
This information is for educational purposes and should not replace professional medical advice. Individual results may vary, and all treatment decisions should be made in consultation with qualified healthcare professionals who can assess your specific circumstances.
