Finding a better way of identifying aggressive prostate cancers

Background

Prostate cancer is the most common cancer in men after non-melanoma skin cancer. An estimated 19,500 men are expected to be diagnosed with prostate cancer in 2019 and around 3,300 men will die of the disease.

There is no single, simple test to detect prostate cancer. Two commonly used tests are the PSA (prostate specific antigen) blood test and the digital rectal examination. However, these tests only show changes in the prostate. They don’t give an indication of whether the changes are benign (non-cancerous) or caused by cancer. Currently, the only way prostate cancer can be confirmed is by a surgical biopsy. In addition, a biopsy is also the only way to identify if prostate cancer is low-risk (growing slowly) or high risk (with the potential to spread and requiring treatment).

The lack of an accurate diagnostic test can lead to over-diagnosis and over-treatment for men with suspected prostate cancer, exposing them to unnecessary risk. Surgical biopsies carry risks of complications, and over-treatment with surgery, chemo-, radio- or hormone therapy can have adverse effects.

A new approach to testing is urgently needed to better identify whether changes in the prostate are benign, low- or high-risk. This will ensure immediate treatment for men with high-risk disease while reducing unnecessary procedures and treatment for men with benign or low-risk tumours.

The research

The role of the nervous system in cancer is not well understood. Professor Hondermarck and his team have discovered that a nerve growth factor (proteins that stimulate the growth of nerves) is overproduced in prostate cancer cells and its presence in the blood is increased in patients with prostate cancer. They’ve also found that this growth factor (called proNGF) is better at identifying prostate cancer from benign prostate growth. This discovery is in line with other recent research that has demonstrated sympathetic nerves (SN) play a significant role in prostate cancer progression.

In light of these exciting findings, Professor Hondermarck and his team aim to show that proNGF and SN are effective biomarkers for prostate cancer and, crucially, represent a more accurate way of testing for the disease.