How Technology, Early Diagnoses Can Help Turn The Tide On Prostate Cancer Prognosis

Dr. Ali Tinazli's post at the Forbes magazine about "How Technology, Early Diagnoses Can Help Turn The Tide On Prostate Cancer Prognosis"

https://www.forbes.com/sites/forbestechcouncil/2022/11/29/how-technology-early-diagnoses-can-help-turn-the-tide-on-prostate-cancer-prognosis/?sh=71a96c562926

Dr. Ali Tinazli is the CEO of lifespin.health and has 15+ years in Fortune 100 corporate strategy and entrepreneurship (SONY, HP).

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There has never been more hope or promise in the global effort to eradicate cancer. Confidence in finding lifesaving cures is at an all-time high among medical researchers who work tirelessly for a solution.

Astounding technological advancements and breakthroughs in the past decade mean we can expect to dramatically shift the cancer diagnosis, treatment and prevention paradigm.

Still, we have a long way to go in the battle to cure many cancers. Take prostate cancer (PC)—the illness continues to rob the lives of thousands of men globally, with young patients blindsided by unexpected diagnoses. When it comes to the young, there are many questions with few definitive answers.

Those diagnosed before 50 with advanced-stage PC may have a genetic predisposition for the disease. For many young men, the prognosis is often dire, and the progression is more aggressive than in older peers at a similar stage and grade.

PC treatments include surgery and radiation therapy, bringing added risks of urinary incontinence and erectile dysfunction. The worry and fear men experience when considering the possible outcomes further fuel the angst of undergoing PC screening.

In the last two decades, the world has seen a sharp uptick in prostate cancer (PC) among the young. An increase in screening men under 55 may catch some cases, but many early-onset cases still go undetected.

Statistics, Risk Factors And The Need For Accurate And Early Detection

In the U.S., 1 in 8 men will be diagnosed with PC. For men, it is the second-most diagnosed cancer globally after lung cancer.

Advanced age, ethnicity, obesity and family history are known risk factors. In particular, overweight or obese men are at a heightened risk for earlier progression and development of metastatic disease, more adverse effects from treatment and a higher likelihood of fatality. Obesity is linked with poorer PC prognosis.

For those with tumors harboring a specific gene fusion, there is a greater risk of recurrence and higher all-cause and prostate cancer-specific mortality.

One way to reduce the burden of this disease on men and their families is to diagnose this highly curable cancer long before it hits a problematic stage. Fortunately, technological advancements and medical discoveries bring real hope in the battle against PC.

The intersection of data science and medicine will undoubtedly further the innovation trajectory in healthcare. Here are a few technological advancements set to pave the way to less invasive treatments and better outcomes for PC patients.

PSMA-PET To Better Detect Metastases

A significant advancement in the treatment of PC, the PSMA PET-CT, uses a radiotracer called 68Ga-PSMA-11. The radioactive targeting molecule seeks out and attaches to a protein on the surface of PC cells. Once the radiotracer binds to the PC cells, they appear as bright spots on a PET scan.

An Australian Prospective Multicenter study suggests PSMA PET-CT is more likely to detect metastases than the conventional approach. Further, PSMA PET detects far more prostate lesions than Fluciclovine PET in men who experienced a cancer recurrence after undergoing radical prostatectomy.

Combining 3-D Ultrasound And MRI For Less Ambiguity

Advancements in technology can now give a medical team a real-time view of the prostate through a guided 3-D ultrasound. As a urologist moves the ultrasound wand over the prostate, advanced software shifts the overlaid MRI image over the organ, allowing suspicious tissue to be digitally marked.

Combining 3-D ultrasound and MRI technology can accurately map biopsy samples. Technological advancements in imaging mean swift and accurate diagnoses of PC with less ambiguity than previously encountered.

Advancements In AI Support The Detection Of PC

AI brings added support for experts in radiology as they detect, classify and characterize PC lesions via scan assessments. Machine learning and deep learning methods can point out a lesion of concern without the need for segmentations or other additional measurements.

AI provides critical information for experts in radiology to fully control the final segmentation. With a sharper view of the lesion, radiologists are better able to accurately diagnose PC and decide on an optimal treatment plan.

Metabolomics Help Identify Aggressive Tumors

A recent study raises the potential for identifying aggressive tumors by discovering metabolite patterns associated with a lower risk of malignant subtypes and cancer-associated death.

Published in the International Journal of Cancer, the study’s authors explain how they identified groups of related metabolites using the statistical method known as “treelet transform.” They then used conditional logistical regression by estimating the association of metabolite patterns with prostate cancer risk.

Metabolic Phenotyping Can Bolster Fight Against PC

From a metabolic research stance, PC is very different from other cancers because prostatic tissue shows high metabolic activity. The study of cancer metabolism holds great interest to researchers focused on metabolomics, and PC is a disease model with tremendous potential. Metabolomic studies have led to discoveries on a better mechanistic understanding of prostate tumors.

Researchers can now assess metabolic fluxes rather than relying on the static snapshot of a traditional blood test. As a result, a deeper understanding of cellular metabolic differences can be realized and aid in discovering potential therapeutic targets.

Advancements in metabolomics may prove relevant in studying the cause of late-stage PC and identifying men at heightened risk of developing aggressive prostate tumors through metabolic phenotyping.

Understanding the metabolic profile differences between benign, low-grade, and high-grade cancer will clarify the progression and lead to new diagnostic testing measures.

Metabolic testing for prostate cancer based on metabolic profiles measured in blood samples brings real promise for assessing the future risk of PC. There is now an opportunity to establish affordable and scalable metabolic profile screening systems accessible to all men as part of routine care.

Survival rates for PC have increased significantly in the past three decades. As we press on and gain traction over this emerging global public health issue, I envision a highly accurate and cost-effective test to diagnose PC before the prostate reaches a diseased state. At the rate things are going, I am confident such a diagnostic test will soon be on the horizon.