A Less Invasive Path to Better Patient Outcomes

Diagnosing prostate cancer can be an invasive process, but a new method of analyzing blood tests is offering hope of a different way forward.

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Prostate cancer stands as the second leading cause of death among males, representing a significant health concern worldwide. A pivotal aspect of managing prostate cancer is accurately diagnosing the disease’s stage.

The stage of prostate cancer is determined based on grades, using the Gleason Score Grade Group. A low-grade means the prostate cells look normal, indicating that the cancer is likely to spread slowly. On the other hand, a high-grade means the prostate cells look abnormal, indicating the cancer is likely to grow quickly.

Currently, diagnosing prostate cancer relies on a prostate-specific antigen blood test, a digital rectal examination, and/or a prostate biopsy. However the first method is not very accurate, especially when diagnosing a high-grade stage of prostate cancer, and the latter two methods are invasive.

Therefore, researchers out of Alberta wanted to figure out a way to accurately diagnose high-grade prostate cancer using the less invasive method alone. They did this by isolating extracellular vesicles (EV) which can be found in patient’s blood samples. EVs are small vesicles found in the blood that have been demonstrated to have diagnostic and prognostic abilities for determining prostate cancer disease stages. This new research study was published in Cancer Medicine and led by Dr. Adrian Fairey from Kipens Urology Centre and Nanostics Inc. in Edmonton, Alberta.

Over 400 males who exhibited elevated levels of prostate-specific antigen, as determined by blood tests, in conjunction with abnormal digital rectal exams were included in the study. Every participant underwent a prostate biopsy, and their blood samples were collected.

The participants’ EVs were isolated from their blood, and using a machine learning platform and an online Prostate Cancer Prevention Trial Risk Calculator the likelihood of having high-grade prostate cancer cells was measured. The researchers called this analysis method the EV-Fingerprint. The EV-Fingerprint results were then compared to the current “standard of care” for prostate cancer diagnoses.

The EV-Fingerprint exhibited remarkable consistency with biopsy results whereby both methods were able to accurately predict high-grade prostate cancer. Additionally, the EV-Fingerprint results outperformed the online Prostate Cancer Prevention Trial Risk Calculator when the EV-Fingerprint was compared to the calculator alone.

All in all, the EV-Fingerprint offered an innovative and effective approach to accurately diagnose prostate cancer stage. Specifically, the EV-Fingerprint was able to diagnose high-grade prostate cancer stage with high specificity compared to the prostate-specific antigen blood test. This promising development for diagnosing prostate cancer significantly reduces the number of missed cases of high-grade cancer as well as offers a less invasive method.

With these advancements, we inch closer to improved prostate cancer patient outcomes and treatment plans, and perhaps a decline in prostate cancer-related deaths.

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Alexandria (Alex) Samson is a PhD student in the Department of Psychology at the University of Toronto. She completed her BSc in Neuroscience from Dalhousie University. Alex is a strong believer in open science and is passionate about making scientific research accessible to all audiences.