Related Experiment Video
Updated: Aug 17, 2026
MR Molecular Imaging of Prostate Cancer with a Small Molecular CLT1 Peptide Targeted Contrast Agent
Published on: September 3, 2013
Diagnosing and treating small-cell carcinomas of prostatic origin
Michael E Spieth1, Y Gregory Lin, Thanhcuong T Nguyen
1Department of Radiology, Marshfield Clinic, Wisconsin 54449, USA. spiethm@mfldclin.edu
Purpose:
Small-cell carcinoma is very aggressive, metastasizes early and often, and does not respond to most chemotherapy regimens. In approximately 50% of cases of prostate cancer, tumors are a combination of small-cell carcinoma and androgen-sensitive adenocarcinoma. It is widely believed that no successful treatment exists for androgen-independent prostate cancer.
Methods:
A 67-year-old man had undergone androgen ablation therapy and radical prostatectomy for prostate cancer followed by bilateral orchiectomy, limited radiation therapy, and unsuccessful chemotherapy for pain-causing metastatic bone disease. Biopsy and immunohistochemical analysis revealed neuroendocrine differentiation of the cancer. The full extent of metastatic disease was assessed successfully using In-111, a somatostatin derivative. Octreotide acetate was used to treat the tumors.
Results:
In-111 OctreoScan scintigraphy was more sensitive in the diagnostic demonstration of metastatic foci than was bone scanning. Therapy with the cold somatostatin derivative resulted in a rapid and significant relief of pain with significant tumor shrinkage. The patient remained in remission for at least 10 weeks, when he was lost to follow-up.
Conclusions:
Somatostatin analogs and their radionuclide and cytotoxic derivatives are recommended as adjuvant treatments for prostate carcinoma, especially in those patients who are at high risk for carcinoma recurrence after radical prostatectomy and who have advanced prostate carcinoma at the time of relapse. Because small-cell carcinomas of the prostate and lung are identical, these analogs may be useful in the detection and treatment of these tumors as well.
Insights
Treatment with somatostatin analogs shows promise for aggressive prostate cancer. This approach, using octreotide acetate, led to significant pain relief and tumor shrinkage in a patient with metastatic small-cell carcinoma.
Area of Science:
- Oncology
- Nuclear Medicine
- Endocrinology
Background:
- Small-cell carcinoma is an aggressive prostate cancer subtype often resistant to chemotherapy.
- Combined tumors of small-cell carcinoma and adenocarcinoma are common in prostate cancer.
- Androgen-independent prostate cancer lacks effective treatment options.
Observation:
- A patient with metastatic prostate cancer, exhibiting neuroendocrine differentiation, was treated with octreotide acetate.
- In-111 OctreoScan scintigraphy demonstrated superior sensitivity for detecting metastatic foci compared to bone scanning.
- The patient received treatment with a cold somatostatin derivative.
Findings:
- Therapy with the somatostatin derivative resulted in rapid pain relief and significant tumor shrinkage.
- The patient achieved a remission lasting at least 10 weeks.
- In-111 OctreoScan proved more sensitive than bone scanning for metastatic disease detection.
Implications:
- Somatostatin analogs are recommended as adjuvant treatments for high-risk prostate carcinoma patients.
- These analogs may be beneficial for detecting and treating small-cell carcinomas in both prostate and lung.
- Further research into somatostatin derivatives for advanced prostate cancer is warranted.
