We welcome today's reports of a new test by scientists at the University of East Anglia to determine whether a prostate cancer is aggressive or not, but the tell-tale pattern of 45 specific genes hasn't yet been proven to work for all men.

1 Mar 2017

One of the great challenges we face in taming prostate cancer is knowing how aggressive each man’s cancer is. If the cancer is unlikely to grow then treatment, such as surgery or radiotherapy, can do more harm than good. Similarly, if a man’s cancer mistakenly appears to be non-aggressive then he might be treated too late to avoid it spreading.

So it’s encouraging that researchers at the University of East Anglia have developed a new categorisation for prostate cancer that could predict more accurately which ones are aggressive.

Improving on the Gleason score to predict tumour changes

We currently rely on a system known as Gleason scoring, where a doctor looks under a microscope at cancer cells taken from a biopsy. The more different the cells look compared to normal cells, the higher the score. While this can give an indication of their current behaviour, it is less reliable for knowing how they will change in the future.

The research team behind this new study, led by Professor Colin Cooper, set out to see if a combination of several characteristics could be better at predicting this future risk. They analysed databases of gene activity in different prostate cancer samples and compared this to how the cancers responded to treatment.

Using a computer algorithm to find a pattern of gene activity linked to aggressiveness, they revealed a set of 45 genes that are less active in more aggressive cancers. So the researchers proposed that cancers that match this pattern should be considered as a new category, named DESNT. However, we still need to see if this result applies to all men and, ultimately, if it can save men’s lives.

Discovery will help build "more complete picture" of cancer

Dr Iain Frame, director of research at Prostate Cancer UK said: "Currently, too many men receive treatments and endure life-changing side effects for cancers that may never cause them harm. This is why Prostate Cancer UK is investing heavily in research to find better diagnostic tests that will transform diagnosis within the next ten years.

"The research results reported today are important because they add crucial information that will help us build a more complete picture of what makes some prostate cancers aggressive. This will undoubtedly help us provide an earlier and more accurate diagnosis and in turn inform us how best to treat the disease."

This is a really important area of research, which we are investing in thanks to your support. We recently announced a PhD studentship for a researcher to study the molecules responsible for the activity of genes. These can be found in blood or urine, which could one day allow doctors to see what treatment is right for each man without the need for a biopsy.

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