Tracer drug – precise cancer staging for Veteran

Air Force Veteran Kenneth Stufflebean is participating in a phase 3 clinical trial at the Harry S. Truman VA in Missouri that is aimed at improving the ability to stage prostate cancer.

A blood test showed an elevated PSA score and a biopsy of his prostate showed extensive cancer. Stufflebean underwent conventional testing with a bone scan and a CT scan to identify the location of the cancer. Both tests showed it was concentrated only in his prostate.

That meant the stage of his cancer would normally be llA, or one-half or less of one side of the prostate. The recommended treatment could be a radical prostatectomy, which is removal of the prostate or radiation only to that gland.

Stufflebean undergoes PET scanning in clinical trial. (Photos by Mindy Roettgen)

“The likelihood for disease is very high.”

But Stufflebean and his doctors took it one step further. Stufflebean received an injection of the radioactive prostate cancer tracer drug being tested in the clinical trial—Ga68-PSMA-11. Afterward, he underwent positron emission tomography (PET) imaging, which uses radioactive substances.

The images showed that the cancer had spread to two lymph nodes in the pelvis, the area below the abdomen that is located between the hip bones and contains the bladder and rectum.

Based on the PET images, the stage of his cancer appeared to be IVA, meaning it had spread to lymph nodes near the internal iliac artery which sends blood to the pelvis.

“Although we do not have tissue confirmation, the likelihood for disease is very high,” says Dr. Thomas Dresser, a nuclear medicine physician who is co-leading the trial. “Based on this information, his treatment is going to be different—probably radiation of the pelvic area.”

Veteran considered trip to West Coast

Stufflebean, 75, served in the Air Force from 1966 to 1970, spending time stateside and in Thailand. He lives about 100 miles from the Truman VA in Marceline, Missouri.

He originally thought about traveling to the University of California, Los Angeles. It has one of two schools approved by the FDA in 2020 to carry out the PET imaging technique using Ga68-PSMA-11.

After consulting with Dresser, who explained to him that the Truman VA had acquired FDA approval to experiment with the drug on an investigational basis, he decided to undergo the procedure right there.

Stufflebean is glad that additional testing found the cancer in his lymph nodes so the treatment plan could be adjusted accordingly.

“I’m very pleased they found it in the lymph nodes,” Stufflebean said. “I’ve been going to VA since 2008. They’ve run a lot of lab tests on me. If it hadn’t been for just giving a PSA blood sample, I wouldn’t have known there was anything wrong with me. You don’t go to the doctor if you feel good. I’ve got no pain but it’s hard for me to control my bladder. The blood test is what showed it right off the bat.”

He expects to begin radiation treatment around the beginning of February.

“I’m anxious to get this started, but I’m just going to do what they tell me to do,” he said.