In UCD Conway Institute, the Pennington and Watson groups have whole-heartedly embraced the challenge of growing and customising their facial hair for this great cause. The day job for each of the team members involves investigating the intricate workings of the disease and finding better tools for clinicians to diagnose prostate cancer earlier and improve the prognosis for patients.
Assessing your risk of getting prostate cancer is an important screening tool. Currently, a prostate biopsy is the standard method that clinicians use to diagnose prostate disease. The procedure itself carries a risk to patients of getting a blood stream infection and places significant costs and burdens on the healthcare system.
There is an unmet clinical need for a better method of assessing a person’s risk of having prostatic disease before moving on to such an invasive procedure as a biopsy. Using a blood test to measure levels of prostate specific antigen (PSA) as a screening tool on its own is not particularly satisfactory.
The Watson group have been working with colleagues in New York University and Galway University Hospitals to assess how two particular prostate cancer risk assessment calculators perform when used on a group of men from the West of Ireland. This unique group of 556 men had never been screened for prostate cancer, never had a prostatic biopsy before the study and only 2% had a family history of the disease.
One of the risk calculators developed in North America (prostate cancer prevention trial risk calculator or PCPT-RC) uses a particular set of criteria while the second was developed in Europe using a different set of criteria (European randomised study for prevention of prostate cancer risk or ERSPC-RC).
This is the first time that these two risk calculators have been validated in a contemporary Irish population. We found the PCPT-RC calculator performed better with this particular group, half of whom were found to have prostate cancer on biopsy. It was also the better tool to predict high grade disease. However, both calculators over-predicted the risk of cancer detection so there is more work to be done. We are now expanding this study to all patients that present to the rapid access clinics across Ireland with a view to building an Irish risk calculator.
Treating localised prostate cancer usually involves a combination of hormone and radiation treatment. For some patients, the disease reoccurs and there are no diagnostic tests that can predict this happening.
Among several prostate cancer projects including studies being undertaken in collaboration with the Dana Farber Cancer Institute at Harvard University, the Pennington group are trying to discover protein signatures in the blood that flag the risk of prostate cancer recurrence. Biomarkers able to address this issue would be of significant advantage to clinicians.
The team published findings of initial work that compared the protein signatures of a patient who experienced disease recurrence after hormone and radiation treatment with that of a patient who remained disease-free after treatment. The work is being undertaken as part of an ICORG clinical trial in association with radiation oncologist, Professor John Armstrong at St Luke’s Hospital.
Of the 287 proteins identified by the team, they saw changes in 95 proteins, selected 16 of these for further analysis and found them to be significantly associated with disease recurrence.
Professor Stephen Pennington, UCD School of Medicine & Medical Science and UCD Conway Institute said
While these results are promising, we need to conduct further research on greater numbers of patient samples to incorporate into our pipeline for biomarker discovery and evaluation and so identify a serum protein signature that can predict or monitor the outcome of treatment of patients with prostate cancer.