A research team from the Norwegian University of Science and Technology (NTNU), led by Professor May-Britt Tessem, has identified specific genetic and inflammatory biomarkers associated with aggressive prostate cancer. Published in Nature Communications, this foundational research combines advanced analytical methods to characterize aggressive forms of the disease.
The study aims to establish a basis for future detection using simpler samples such as blood or semen, ultimately seeking to improve the early identification of high-risk patients and reduce overtreatment for those with slower-developing forms.
Context of Prostate Cancer
Prostate cancer is the most common cancer among men in Western countries. Studies indicate its presence in approximately 50 percent of men over 60 and about 70 percent of men over 80, directly linking it to aging.
While many prostate cancers develop slowly, allowing men to live well without treatment, some cases involve an aggressive variant that can recur even after surgical removal. Approximately 30% of patients experience cancer recurrence after surgery, with an average of nine years between surgery and relapse. The ability to distinguish between indolent and aggressive forms is crucial for improved diagnostics and treatment strategies.
Current detection methods typically involve rectal examinations, PSA (Prostate-Specific Antigen) blood tests, and MRI scans to assess the prostate gland. The increase in PSA testing has contributed to a rise in new cases, with about 5200 new cases yearly in Norway. However, determining which patients require intensive follow-up remains a resource-intensive process, and men sometimes avoid examinations.
Research Methodology and Key Findings
The NTNU research team is noted for being the first to combine advanced research methods for detecting aggressive prostate cancer. Their large-scale study analyzed prostate tissue using genetic data, metabolic analyses, and detailed tissue images. This provided a spatially resolved multi-omics approach that included transcriptomics, metabolomics, and histopathology to create a three-dimensional view of the tumor microenvironment.
The findings revealed two significant characteristics associated with aggressive prostate cancer:
- Aggressive Cancer's Genetic Signature: Researchers identified a specific gene expression pattern within the tumor tissue of patients at a high risk for cancer recurrence and spread. This signature could potentially aid in distinguishing patients who require intensive care from those who might need less aggressive follow-up.
- Inflammation in Surrounding Tissue: Signs of inflammation and altered metabolic processes were observed in seemingly normal tissue adjacent to cancerous tumors. These areas exhibited high activity of neurotransmitters that attract immune cells, an increased presence of cell types capable of triggering inflammatory reactions, and decreased levels of essential substances, indicating a loss of normal gland function.
Professor Tessem stated that aggressive prostate cancer appears to be linked to inflammation surrounding cancer cells, specific genetic signatures, and metabolic changes within the prostate tissue.
Implications for Future Diagnostics and Treatment
This research aims to establish a basis for easier screening for aggressive cancer, potentially using simple blood or sperm samples, which could lower the threshold for early detection. A primary goal is to prevent overtreatment, as current prostate cancer treatments can significantly reduce quality of life through side effects such as incontinence, erectile dysfunction, and depression. Many patients are currently overtreated, experiencing unnecessary discomfort.
While this basic research, which uncovers new cancer-related characteristics and correlations, is not yet ready for clinical use, it lays a foundational understanding for future diagnostic and treatment breakthroughs.