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Scientists find five different types of prostate cancer

Discovery raises hopes of ability to distinguish more effectively between ‘pussy cat’ and ‘tiger’ tumours

Caroline White

Thursday, 30 July 2015

There are five different types of prostate cancer, each of which have their own discernible genetic characteristics, finds research* published today in EBioMedicine.

The findings have raised hopes that the discovery may help identify tumours that are more likely to grow and spread aggressively through the body with greater precision than is currently possible.

The researchers, from the Cancer Research UK Cambridge Institute and Addenbrooke’s Hospital, studied samples of healthy and cancerous prostate tissue from more than 250 men.

By looking at abnormal chromosomes and measuring the activity of 100 different genes linked to the disease, the researchers were able to group the tumours into five distinct types, each with a characteristic genetic fingerprint.

This analysis was better at predicting which cancers were likely to be the most aggressive than the tests currently used — including the PSA test — and Gleason score. But the findings need to be confirmed in clinical trials with larger groups of men, caution the researchers.

“Our exciting results show that prostate cancer can be classified into five genetically different types. These findings could help doctors decide on the best course of treatment for each individual patient, based on the characteristics of their tumour,” commented study author Dr Alastair Lamb from the Cancer Research UK Cambridge Institute.

“The next step is to confirm these results in bigger studies and drill down into the molecular 'nuts and bolts' of each specific prostate cancer type. By carrying out more research into how the different diseases behave we might be able to develop more effective ways to treat prostate cancer patients in the future, saving more lives,” he suggested.

Prostate cancer is the most common cancer in men in the UK, with around 41,700 cases diagnosed every year, and around 10,800 annual deaths from the disease.

Professor Malcolm Mason, of Cancer Research UK, commented: “The challenge in treating prostate cancer is that it can either behave like a pussycat—growing slowly and unlikely to cause problems in a man's lifetime—or a tiger, spreading aggressively and requiring urgent treatment. But at the moment we have no reliable way to distinguish them. This means that some men may get treatment they don’t need, causing unnecessary side effects, while others might benefit from more intensive treatment.”

He continued: “This research could be game-changing if the results hold up in larger clinical trials and could give us better information to guide each man’s treatment—even helping us to choose between treatments for men with aggressive cancers. Ultimately this could mean more effective treatment for the men who need it, helping to save more lives and improve the quality of life for many thousands of men with prostate cancer.”

* H. Ross-Adams, et al. Integration of copy number and transcriptomics provides risk stratification in prostate cancer: A discovery and validation cohort study. EBioMedicine, 2015. DOI: 10.1016/j.ebiom.2015.07.017

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