Medical researchers believe they may have unearthed a potential new way of testing how advanced a patient’s prostate cancer is, which may one day be used to tailor treatments for patients.
QIMR Berghofer Medical Research Institute senior research officer Dr Carolina Soekmadji has identified potential biomarkers for advanced prostate cancer.
The extracellular vesicles (EVs), which are enclosed lipid membranes secreted by cells, provide information on the lipid, protein and nucleic acid content of the cancer cells.
Dr Soekmadji said the secretion of a particular type of EV was higher in patients with prostate cancer than it was for men who had an enlarged, but benign, prostate. The same cescivle was also found in higher numbers in patiens with advanced prostate cancer, providing a strong connection that these are potential biomarkers.
The EVs can be measured via a simple blood test, offering a less invasive way to detect prostate cancer.
The secretion of these vesicles by prostate cancer cells is also influences by the presence of androgen, a male hormone that is widely known to drive prostate cancer growth.
‘While further investigation is needed, this tells us that the presence of EVs could be important not only as a prostate cancer biomarker for diagnosis and prognosis, but may allow clinicians to make a more informed decision regarding treatment regimes,’ Dr Soekmadji said.
Androgen Deprivation Therapy (ADT) is a common hormonal treatment for advanced prostate cancer, but often causes many unpleasant side-effects, including hot flushes, decreased libido, erectile dysfunction, the development of breast tissue, abdonimal obesity and osteoporosis. However, there are some patients who experience treatment benefits without the side-effects.
‘We hope that clinicians can use this biomarker information to identify patients who will have a positive response to Androgen Deprivation Therapy in the not too distant future,’ Dr Soekmadji said.
Murray McLachlan, 64, knows the many treatment pathways of a prostate cancer diagnosis first-hand. Murray was diagnosed with prostate cancer nine years ago, after receiving a high PSA reading and biopsy results revealing he had advanced stage prostate cancer. Due to the advanced stage of the cancer, his treatment involved having a surgical radical prostatectomy using the Da Vinci robotic machine.
‘After speaking with my oncologist, other forms of treatment, including ‘watchful waiting’, ADT and brachytherapy, were not viable options. His view was that a radical prostatectomy via the robotic machine was the best option,’ Murray said.
‘It is unfortunate that possible side effects are too often presented as major reasons for not going ahead with the procedure. In my experience, there aren’t many men who have regretted having taken the surgical option, when not having done so many have resulted in a premature death,’ he said.
Understandably, prostatectomy may not be the preferred treatment method for everyone, so specifically knowing which treatments will be effective for which patients is the way forward for tackling this stealthy cancer.
Murray firmly believes that any additional detection information that may result, for example from Dr Soekmadki’s work on biomarkers, is certainly a good thing from the perspective of those facing a prostate cancer diagnosis.
‘We also hope that one day clinicians may be able to use this information to tailor therapies to suit the biological background and make-up of each individual patient,’ Dr Soekmadji said.