A major leap in prostate cancer care is landing in Victoria this month, giving Victoria patients access to two of the most advanced diagnostic and treatment tools available in Canada.
BC Cancer – Victoria will soon begin offering prostate-specific membrane antigen (PSMA) positron emission tomography (PET) scans and Pluvicto (lutetium vipivotide tetraxetan) therapy – technologies that specialists say are already reshaping how prostate cancer is diagnosed, treated and survived.
The imaging technology is already accessible in Vancouver, where clinical trials started in 2017. It became available in Kelowna in May and is coming to Victoria later this month.
“This is actually really, really big news,” said Dr Abraham Alexander, a radiation oncologist at BC Cancer. “Both are really tremendous advances, and they're going to make a huge impact in our ability to treat prostate cancer patients in B.C.”
The rollout marks a new chapter for men with prostate cancer, the most common cancer in Canadian men aside from skin cancer, and the third-leading cause of cancer death in that group.
About 4,165 people are expected to be diagnosed with prostate cancer in B.C. this year, and roughly one in every 30 men in the province will die from it.
One of the biggest breakthroughs comes in the form of a scan that can detect cancer earlier and with greater precision.
PSMA PET scans use a radioactive tracer to find cancer cells by targeting a specific protein found on their surface, in this case, PSMA.
“It’s the most advanced type of imaging for picking up where prostate cancer is in the body,” Alexander said. “It can pick up very small amounts of prostate cancer anywhere in the body – much earlier than conventional imaging.”
Traditional CT and bone scans require cancer to be more advanced before it can be detected.
“For a regular CT scan or bone scan, the PSA test has to be in the range of 10 or 20 before we're able to pick up cancer,” Alexander said. “This new PET scan can pick up cancer when the PSA is 0.2. So much, much earlier.”
The scan’s arrival in Victoria is expected to significantly cut waitlists.
About 500 scans will be performed each year locally, helping patients get answers faster and easing pressure on the provincial system.
But diagnosis is only part of the equation. For patients whose cancer has already spread or come back after treatment, a new therapy called Pluvicto is offering fresh hope.
“What this is, is a very specific targeted treatment,” Alexander said. “You inject it in, the treatment goes right to the prostate cancer cells and the radiation kills it.”
The treatment will be delivered intravenously at BC Cancer – Victoria starting this month.
“This treatment is for people who really don't have a lot of hope because we have nothing else for them,” Alexander said. “And this particular drug that we now have is able to give them hope – because we know it does improve survival and make people in that situation live longer.”
Both PSMA PET scans and Pluvicto are part of a larger shift in cancer care known as theranostics, which blends diagnostics and therapy using the same molecular target – in this case, the PSMA protein.
“This is a new paradigm,” Alexander said. “The hope is that in five or 10 years, we may have similar paradigms for other cancers.”
In 2021, the BC Cancer Foundation launched a campaign to bring PSMA PET to Victoria and Kelowna. More than 1,000 donors contributed a combined $6.4 million for equipment, renovations and startup costs.
That progress is already visible in patient outcomes.
When Dr. Alexander started in Victoria in 2006, treatment options for men with advanced prostate cancer were limited and bleak.
“Nowadays, we see the same patients live five years, six years, even seven or eight years longer,” Alexander said. “Quite often I see men whose prostate cancer has spread, and with these new treatments we have, I’m often telling them they may live a normal lifespan.”
Alexander also emphasized the importance of early screening using the PSA test, which can catch prostate cancer before symptoms appear and improve long-term survival.
“I would highly recommend everyone talks with their family doctor about PSA tests for early detection," Alexander said. "With these advances now available here in Victoria, we’re not just catching cancer earlier – we’re saving lives.”
