Scientists find way to help predict prostate cancer a decade in advance

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Scientists have discovered a new way to help predict which men may develop prostate cancer, more than a decade before they do.

The work from a team at Oxford University also found proteins linked to aggressive forms of the disease, pinpointing with more accuracy which cancers may become life-threatening.

The largest study of its kind found clear biological differences between men who later developed prostate cancer and those who did not.

The research examined blood samples from 982 men who later developed prostate cancer. A further 1,573 men, randomly selected from the European Prospective Investigation into Cancer and Nutrition, were also included.

The results were published in European Urology and presented at the American Society of Human Genetics (ASHG) annual meeting.

Researchers measured more than 6,000 proteins in the blood and participants were followed up for around 16 years.

Overall, 12 proteins were found that were linked to prostate cancer diagnosed more than 15 years later including GZMK, a protein produced by immune cells involved in recognising and destroying abnormal cells.

This suggests immune systems in the body could be keeping prostate cancer in check long before it is diagnosed, the team said.

The researchers also identified seven proteins linked to aggressive prostate cancer.

One of these, ANKRD1, was found in cancers that spread or cause early death.

The study also advanced knowledge around how cancer cells interact with surrounding tissue, and how new blood vessels form.

Dr Zhe Huang, first author of the study and a postdoctoral epidemiologist at Oxford Population Health, said: “Prostate cancer is not one disease. Many prostate cancers grow slowly and may never cause harm, while others are aggressive and can be life-threatening.

‘By measuring thousands of proteins in blood collected years before diagnosis, we can begin to investigate how men who later develop aggressive prostate cancer may differ from men who do not.

“Ultimately, we hope this will help us understand the biology of aggressive prostate cancer and identify markers that could improve how we assess risk in the future.”

According to Prostate Cancer UK, more than 63,000 men are diagnosed with the disease every year and more than 12,000 die from it.

Early prostate cancer often has no symptoms, but in the later stages can include changes in urinary habits such as weak flow or needing to go more often.

Other signs include blood in the urine or semen, pain in the back, pelvis or hips, unexplained weight loss and erectile dysfunction.

Many cases progress too slowly to cause problems or early death, but some cases are very aggressive.

The new study also found links with blood levels of proteins produced by genes already known to be important in prostate cancer, including ERBB3, KRAS and NRAS.

These were linked to aggressive prostate cancer diagnosed around a decade later.

Researchers said this does not mean cancer was already present when the blood was collected, but the findings may provide clues to biological changes that mean men then develop the disease.

Prostate cancer usually starts to grow on the outer part of the prostate. If this happens, it can cause changes to the way you pee, such as:

Professor Karl Smith-Byrne, a senior author of the study, said: “Finding proteins linked to known prostate cancer driver genes in blood collected years before diagnosis gives us new insights into the earliest stages of the disease.

“Together with existing and future genetic evidence, these findings may help us identify biological pathways that could be targeted to prevent aggressive prostate cancer.”

More research is needed before the proteins could be used as tests for the disease.

Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK, which part-funded the study, said: “Prostate cancer is one of the biggest cancer killers of men, yet we still don’t fully understand why some tumours grow slowly and may never cause harm, while others become aggressive and life-threatening.

“Understanding what drives these differences is crucial if we are to identify those most at risk and ultimately save more lives.

“This research offers important new clues…

“While there is more work to do, discoveries like this could pave the way for better ways to identify men at risk and, ultimately, prevent aggressive prostate cancer before it develops.”

Professor Prabhakar Rajan, from Queen Mary University of London, welcomed the study but said “it does not yet establish that a protein-based blood test can reliably identify men who will develop aggressive prostate cancer or is ready for routine clinical use”.

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