DORVAL, QC, Oct. 5, 2026 /CNW/ -- The Canadian Urological Association (CUA) has published a multidisciplinary expert report offering Canadian consensus recommendations on prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) imaging and lutetium-177 PSMA-targeted radioligand therapy (¹⁷⁷Lu-PSMA-617) for patients with prostate cancer.
Published in the October 2026 issue of the Canadian Urological Association Journal (CUAJ), the report is one of the most comprehensive Canadian efforts to date to establish practical guidance for clinicians navigating rapidly evolving molecular imaging and targeted radionuclide therapies.
Addressing a changing landscape in prostate cancer care
Prostate cancer remains the most commonly diagnosed cancer among Canadian men. PSMA-targeted imaging and therapy have significantly advanced the detection, staging, and treatment of prostate cancer, often identifying disease not visible through conventional imaging.
The report summarizes 32 consensus statements developed through a structured modified Delphi process involving 17 Canadian experts from multiple disciplines--urology, medical oncology, radiation oncology, and nuclear medicine--and institutions across the country. Consensus was achieved for 59% of clinical questions and 87% of nuclear medicine-specific questions considered.
Key recommendations:
- PSMA PET/CT should be used for staging high-risk and very high-risk localized prostate cancer, biochemical recurrence, and oligoprogressive disease whenever feasible.
- Negative PSMA PET/CT findings should not be used to withhold otherwise indicated salvage radiotherapy or pelvic lymph node treatment.
- Solitary PSMA-positive lesions without supporting imaging or clinical findings should be interpreted cautiously and should not automatically be considered metastatic disease.
- Treatment decisions involving ¹⁷⁷Lu-PSMA-617 should be guided by multidisciplinary teams, particularly for patients with complex clinical situations including kidney impairment, compromised bone marrow reserve, or prior radionuclide therapies.
- Monitoring during PSMA-targeted treatment should incorporate clinical assessment, prostate-specific antigen (PSA) testing, and appropriate imaging to provide a comprehensive picture of response.
The panel also addressed areas of continuing uncertainty, including equivocal imaging findings, biochemical recurrence, oligometastatic disease, treatment sequencing, and monitoring strategies. Its goal is to support the thoughtful and consistent use of these technologies while reducing the risks of overdiagnosis and overtreatment.
About the CUA
The CUA promotes the highest standard of urologic care for Canadians and advances the art and science of urology through education, research, and advocacy.
Website: www.cua.org
SOURCE Canadian Urological Association
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