The Headlines:

DNA prostate test ‘will predict deadliest cancer risk’ — BBC

Found: aggressive prostate cancer gene — Independent Online

Researchers closer to genetic test for aggressive prostate cancer — The Raw Story

The Science:

What is Prostate Cancer? Prostate cancer is the second most common cancer among American men, affecting over 200,000 patients per year, and causing nearly 30,0o0 deaths (American Cancer Soc.). It is caused by abnormal cell growth in the Prostate Gland, a walnut-sized gland that sits around the urethra — the tube that carries urine out of the body. The risk factors for Prostate Cancer are various, including age (over 60), alcohol consumption, smoking, obesity, and also a strong genetic component, as we see Prostate Cancer more commonly both within families and among certain ethnic groups (especially African Americans).

One of the biggest challenges in treating Prostate Cancer is that it comes in several difficult to distinguish forms, each with a markedly different prognosis and preferred course of treatment; many Prostate Cancers are relatively benign, slow-growing tumors that pose a relatively low risk of metastasis (cancer spread to other organs) and death. However, there are also extremely dangerous forms of Prostate Cancer that are highly aggressive, growing fast and spreading rapidly throughout the body. Current tests rely on histological analysis (visual characterization of the cells in a biopsy sample under a microscope) to give a “risk factor”, known as a Gleason score, on which the course of treatment is based — the higher risk of the cancer being a high-grade tumor, the more aggressively the doctors will treat it. More accurate tests would therefore be extremely valuable in determining which patients require early and aggressive treatment, but also better identify those with low-grade tumors that are better left mostly alone and monitored, rather than undergoing aggressive treatment and the variety of unpleasant side-effects that can entail.

What did the Scientists Find? A team of scientists from the Institute of Cancer Research in London tested 191 men who had Prostate Cancer, as well as a family history of Prostate Cancer, for a number of genetic variants that are associated with high risk of other cancers, including the famous BRCA genes that are associated with Breast and Ovarian Cancers in women. They found that 7% of the patients carried at least one of these high-risk genes, and that these patients were predominantly the ones with high-grade, aggressive tumors. This implies that screening men for some of these genes may be a useful test in determining how aggressive their tumor is likely to be, and therefore how aggressively it should be treated.

What’s the Next Step? This study is what’s known as a proof-of-concept: the scientists showed that in this [relatively small] group of patients that there is a correlation between the patient’s genetic makeup and the relative severity of his disease. In order to find out if this discovery could lead to a genetic screen that would help doctors assess a patient’s condition and individual risk, there needs to be further studies that look at much larger populations, and comparing patients with Prostate Cancer to healthy individuals to ensure that such a test does not lead to ‘false positives’, where healthy people are incorrectly diagnosed as high-risk. This team is now expanding their study to include 2,000 individuals, and will look at a broader group of 192 genes associated with cancer risk, rather than just the 14 high-risk genes used in this initial study. If larger trials are able to confirm a strong correlation between a patient’s genetic makeup and the likelihood and severity of their experiencing Prostate Cancer, then genetic analysis could become a standard test for men diagnosed, or identified as high-risk for Prostate Cancer.

What Does this Mean for Me?

One in seven men will experience Prostate Cancer at some point in their lives. If this study is confirmed, and researchers are able to identify genetic factors that contribute to the severity of the disease, then genetic screening would likely become an essential part of diagnosis and planning of treatment for men with Prostate Cancer. Assuming this research shows that to be true, it will likely be 3-5 years before this test becomes part of the standard clinical assessment process.

If you experience symptoms of Prostate Cancer, you should go see a doctor immediately to check out if you have early stage Prostate Cancer . These symptoms include one or more of: an increase in how often you need to urinate, trouble initiating a urine stream, pain when urinating or ejaculating, blood in your urine, and frequent stiffness in your lower back, hips and thighs. This is especially important if you are a person at elevated risk of Prostate Cancer; if you are over 60, African American, have a family history of Prostate Cancer, are overweight, smoke, and/or have been exposed to chemicals such as Agent Orange in your lifetime, you are at higher risk than the rest of the population. You can decrease your risk of developing Prostate Cancer (as well as many other nasty diseases) by living a healthy lifestyle, eating well (i.e. eat plenty of fruits and vegetables, and minimize intake of red meat and fatty foods), and getting daily exercise.