Greco et al (2008) stated that the patient population with a rising PSA post-therapy with no evidence of disease on standard imaging studies currently represents the second largest group of prostate cancer patients. Little information is still available regarding the specificity and sensitivity of PET tracers in the assessment of early biochemical recurrence. Ideally, PET imaging would allow one to accurately discriminate between local versus nodal versus distant relapse, thus enabling appropriate selection of patients for salvage local therapy. The vast majority of studies show a relatively poor yield of positive scans with PSA values less than 4 ng/ml. So far, no tracer has been shown to be able to detect local recurrence within the clinically useful 1 ng/ml PSA threshold, clearly limiting the use of PET imaging in the post-surgical setting. Preliminary evidence, however, suggested that 11C-choline PET may be useful in selecting out patients with early biochemical relapse (PSA less than 2 ng/ml) who have pelvic nodal oligometastasis potentially amenable to local treatment. The authors concluded that the role of PET imaging in prostate cancer is gradually evolving but still remains within the experimental realm. Well-conducted studies comparing the merits of different tracers are needed.
Man made (synthetic) corticosteriods are used to treat a large number of conditions and symptoms. Corticosteriods are used as a replacement therapy when the body is not naturally producing enough of its own of natural corticosteriods. They are also used to treat conditions where there is inflammation, autoimmune conditions or allergy symptoms. Corticosteriod can be taken orally as a systemic treatment to treat the body as a whole or it can be applied to the affected area for a local effect as creams, inhalations, nasal sprays, eye drops, ear drops or injections. Examples of conditions they treat are allergies, asthma, COPD, dermatitis, ulcerative colitis, Crohn’s disease, multiple sclerosis, nephrotic syndrome, adrenal insufficiency, inflammation, Addison’s disease, rheumatic conditions such as arthritis, fibromyalgia and lupus.