Researchers at the Boston University Medical Center, NorthShore University HealthSystem and Northwestern University developed a new nanotechnology capable of identifying tumor risk and especially of predicting cancer progression. The study is entitled “Nanocytological Field Carcinogenesis Detection to Mitigate Overdiagnosis of Prostate Cancer: A Proof of Concept Study” and was recently published in the journal PLOS ONE.
Prostate cancer is the second most common cancer in men, with almost one million new cases diagnosed every year worldwide. It is a curable cancer that can range from slow-growing tumors (more common) to rapidly progressing aggressive tumors. An early diagnosis of the disease is crucial and it can be made through a blood analysis for prostate-specific antigens (PSA). However, this recommended screening tool is currently being debated because it is unable to predict which of the individuals with high PSA levels will actually develop an aggressive cancer. Therefore, better prognostic tools are required.
Clinicians believe that prostate cancer might be often over-diagnosed and over-treated, resulting in unnecessary therapeutic interventions, discomfort and possible complications (like urinary, bowel and erectile dysfunctions). It is estimated that by the age of 80, around 60% of men will have developed the disease but not all will develop the fatal, aggressive form of the cancer.
This study reveals a new method that can aid physicians on the decision-making process regarding whether or not to submit a patient to aggressive prostate cancer treatment, by helping identify which tumors are likely to progress into life-threatening forms and which will remain non-aggressive.
“If we can predict a prognosis with our technology, then men will know if their cancer is dangerous and if they should seek treatment,” said the study’s senior author Dr. Vadim Backman in a news release. “Right now there is no perfect tool to predict a prognosis for prostate cancer. Our research is preliminary, but it is promising and proves that the concept works.”
This new method is based on an optical technique called partial wave spectroscopic (PWS) microscopy. PWS allows the identification of cell features as small as 20 nanometers (a billionth of a meter), revealing cell differences that would not be detected by standard microscopy techniques. PWS can lead to earlier, life-saving interventions and has been successfully tested in recognition of lung, colon and pancreatic cancers. In this study, PWS was used for the first time not only to identify the risk of prostate cancer, but also to predict a cancer prognosis.
“The goal is to find specific biomarkers of aggressive cancers,” said one of the study’s lead authors Dr. Charles Brendler. “These biomarkers will allow us to individualize our treatment recommendations and improve patient outcomes.”
Researchers assessed prostate tissue biopsies from two different cohorts of patients, comprising in total 18 men with non-progressing cancers and 20 with progressing cancers. During the analysis, the PWS operator was unaware of the patients’ clinical status. It was found that progressing cancers have a dramatic increase in nano-architectural disorder in comparison with non-progressing cancers. The team believes that this characteristic could potentially be used as a powerful biomarker to predict cancer progression in early-stage prostate cancers.
“This study has high quality data because it was done in a blinded fashion,” noted Dr. Backman. “Given that even in the unblinded dataset the investigator responsible for data acquisition was unaware of the clinical status, there is no possibility of bias.”
The research team plans to conduct further studies with the PWS technology and to test its capability as an accurate prognostic tool for other cancers, such as breast, ovarian and esophageal cancers.
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