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New AI Tools Predict Which Men Will Respond to Prostate Cancer Treatments

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Medical professionals have created an artificial intelligence tool capable of predicting which men diagnosed with prostate cancer are likely to benefit from treatment, potentially lowering the risk of mortality.

Abiraterone is regarded as a revolutionary treatment for the condition, which is the most prevalent cancer among men in over 100 countries. It has already enabled countless individuals with advanced prostate cancer to enjoy extended lifespans.

Nonetheless, some nations, including the UK, have ceased offering this “remarkable” medication to men whose cancer has not metastasized.

Currently, teams from the US, UK, and Switzerland are developing AI assessments that determine which men are likely to gain from Abiraterone. This “promising” advancement enhances the healthcare system to allocate medications more effectively to suitable candidates while allowing others to avoid unnecessary treatments.

The AI test was unveiled in Chicago at the annual conference of the American Society of Clinical Oncology, the largest cancer conference globally.

Nick James, a professor specializing in prostate and bladder cancer research at the London Cancer Institute, serves as a consultant clinical oncologist at the Royal Marsden NHS Foundation Trust, where he leads the development team.

“Abiraterone has already greatly enhanced the prognosis for hundreds of thousands of men with advanced prostate cancer,” James stated. “We recognize that for many men whose cancer hasn’t spread yet, it can have significant implications.

“However, the treatment comes with side effects and necessitates additional monitoring for potential issues such as hypertension or liver abnormalities. It is extremely valuable to identify those most likely to truly benefit, as it may slightly elevate the risks of diabetes and heart complications.

“This research indicates that those who respond optimally to abiraterone, as well as those who fare well with standard treatments alone, can decide between hormone therapy and radiation therapy.”

The AI tool examines tumor images and identifies features that may not be discernible to the naked eye. Prostate Cancer UK, the Medical Research Council, and arterial funded teams analyzed biopsy images from over 1,000 men exhibiting high-risk prostate cancer that had not metastasized.

AI analysis pinpointed 25% of the men in the study who were most likely to gain from Abiraterone. For these individuals, the medication halved the risk of mortality.

In the study, patients received a score indicating a positive or negative biomarker. This was then compared with outcomes. Among those with biomarker-positive tumors, the risk of death was reduced from 17% to 9% after five years for one in four men.

For patients with biomarker-negative tumors, Abiraterone decreased the risk of death from 7% to 4%. The research team indicated this result was neither statistically nor clinically significant, meaning these men are better off with standard treatment alone and can avoid unnecessary therapies.

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Professor Gert Attard, the research co-leader at UCL Cancer Institute, noted, “This study highlights that, within a sizable cohort of patients, new algorithms can be utilized to glean information from routinely available pathology slides to customize treatments to individual patients, thereby minimizing unnecessary interventions while maximizing the effectiveness of treatment.”

James mentioned that fewer men may require the medication than previously believed, suggesting that health services should contemplate administering it to men whose cancer hasn’t spread.

While it has been sanctioned for use within the NHS for advanced prostate cancer in England, it has yet to receive approval for newly diagnosed high-risk cases that have not metastasized. However, men with indications of high-risk cancer have had access to treatment in Scotland and Wales for two years.

“Abiraterone costs just £77 per pack compared to thousands for new treatments,” James remarked. “We sincerely hope this new research will clarify who truly benefits from this drug, especially given NHS England’s decision not to fund it for high-risk non-metastatic prostate cancer cases.”

Dr. Matthew Hobbs, research director at Prostate Cancer UK, termed the AI test as “promising.” He further elaborated:

Source: www.theguardian.com

Factors That Truly Influence Your Prostate Cancer Risk

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Prostate cancer is the most prevalent cancer among men, with roughly one in eight men receiving a diagnosis in their lifetime. Nevertheless, not all prostate cancers are life-threatening; in fact, many develop slowly and remain harmless.

“There are essentially two categories of prostate cancer,” Dr. Haley Luxton, who studies the impact of prostate cancer in the UK, explains. “I refer to them as ‘pussycats’ and ‘tigers.’ Pussycats are the slow-growing types, which typically do not lead to death.”

“On the other hand, tigers are highly aggressive forms of prostate cancer, and these men require immediate treatment to prevent mortality.”

Autopsy research indicates that over 50% of men over 90 have prostate cancer cells, many of whom were never diagnosed during their lifetime.

“Most men will eventually have prostate cancer cells,” adds Dr. Cody Watling, a postdoctoral researcher at the National Cancer Institute. “However, whether it becomes clinically significant—causing symptoms or spreading—is an entirely different issue.”

Three Key Risk Factors

What really increases your risk of prostate cancer?

According to science, there are three major factors—sadly beyond your control:

  • Age – The risk increases significantly after age 50, with most diagnoses occurring in men over 70.
  • Ethnicity – Black men are twice as likely to develop prostate cancer as their white counterparts. The reasons remain unclear, although genetics may play a role.
  • Family History – If your father, brother, or grandfather had prostate cancer, your risk is elevated—especially if the diagnosis occurred before age 60. The BRCA2 gene is a contributing factor.

Watling notes that these risk variables are generally linked with both prostate cancer and more aggressive forms of the disease. “Evidence suggests that age, family history, and being Black increase the overall risk of aggressive prostate cancer.”

More than 50% of men over 90 have prostate cancer cells, but many are benign. – Getty

Lifestyle Considerations

While some reports suggest that lifestyle choices can reduce risk, the situation is complex.

Watling, who researched diet and prostate cancer risk at Oxford University, stated, “To date, strong evidence has been elusive.”

Some studies indicate a potential link between high consumption of dairy, particularly milk, and slight increases in prostate cancer risk, likely due to a growth factor known as IGF-1. However, Watling emphasized, “The evidence remains ambiguous, and there is no robust connection.” More research is necessary to clarify these relationships.

One possible exception is obesity. “There is some evidence suggesting that being overweight correlates with a higher risk of aggressive or fatal prostate cancer,” says Watling. “However, it’s challenging to determine if this is biological or due to less frequent early screening in heavier individuals.”

Luxton concurs: “Maintaining a healthy, balanced diet and engaging in some form of physical activity—even just a ten-minute walk—can be beneficial.”

Recommendations

If you are over 50, or over 45 with a higher risk (due to family history or being Black), Prostate Cancer UK advises initiating a conversation with your GP.

You can assess your risk in just one minute with the Prostate Cancer UK Online Risk Checker.

Your doctor may then conduct various screening tests, including prostate-specific antigen (PSA) blood tests, examinations, and MRI scans as necessary.

In Conclusion

Joe Biden’s diagnosis understandably alarmed many, but it also led to a surge of misleading or overly simplistic guidance. Here are the facts:

  • The risk of prostate cancer cannot be entirely eliminated.
  • Most risks are linked to age, family history, and ethnicity, rather than diet or lifestyle factors.
  • Nevertheless, healthy habits remain important for reducing the risk of aggressive prostate cancer and other diseases.
  • If you are at high risk, it’s crucial to speak with your doctor.

About Our Experts

Hailey Luxton is the Head of Research Impact and Engagement at Prostate Cancer UK, tasked with identifying initiatives that can significantly influence the charity’s research program and expedite research projects. Previously, he conducted research at University College London and Cancer Research UK.

Cody Watling is a postdoctoral researcher at the National Cancer Institute. His research has been featured in publications such as BMC Medicine, Clinical Nutrition, and British Journal of Cancer.

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Source: www.sciencefocus.com

Here’s what we often misunderstand about prostate cancer.

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Joe Biden’s recent prostate cancer diagnosis has brought awareness to these health issues within the public discourse.

Prostate cancer charities are urging men across the country to assess their cancer risk through signs and to seek medical advice if they experience symptoms like frequent and uncontrollable urination. Nevertheless, prostate cancer remains a nuanced and intricate condition.

The prostate gland is located beneath the bladder and typically enlarges with age. The urethra, which drains urine from the bladder, passes through the prostate. Consequently, when the prostate enlarges, it can compress the urethra, impeding urine flow and leading to symptoms such as dribbling and increased urgency to urinate. Overall, this is a prevalent condition.

Likewise, the incidence of cancers originating in the prostate is quite common. Autopsy studies indicate that 36% of white individuals and 51% of African Americans had unreported prostate cancer. In the 1970s, he was diagnosed with prostate cancer.

Photo credit: Getty

Another study suggested that five percent of men under 30 lived with prostate cancer. This may seem surprising, but these cancers were identified during autopsies of men who passed away from other causes. Medical professionals have long maintained certain sayings, such as “That’s how I die from prostate cancer.”

This presents a significant challenge concerning prostate cancer. It can manifest in a form that causes minimal harm while also possessing a variant that is potentially lethal and can metastasize to nearby organs and bones.

How Dangerous Is Prostate Cancer?

Currently, prostate cancer accounts for approximately 35,000 deaths in the U.S. each year, with over 313,000 men diagnosed annually.

The key to addressing this issue lies in identifying which cases pose a threat, as treatments like surgery, radiation therapy, and hormone therapy may have side effects such as long-term erectile dysfunction and incontinence.

It is essential that patients avoid unnecessary treatments that do not benefit them.

Unfortunately, there is currently no straightforward method to differentiate between aggressive tumors and those that are indolent. A blood test known as the PSA (prostate-specific antigen) test was created in the 1990s to monitor men’s responses to prostate cancer treatments.

Following its introduction, the number of diagnosed prostate cancer cases surged, yet there was no corresponding decrease in mortality rates.

This led Richard Alvin, the researcher who developed the PSA test, to remark, “The widespread use has resulted in a costly public health crisis.” This is due to the PSA test potentially generating false positives caused by factors aside from prostate cancer, including infections and benign prostate enlargement.

In the U.S., the Preventive Services Task Force reviews research independently and issues recommendations regarding screening.

They state that PSA screening can marginally lower the risk of death from prostate cancer in some men. However, many men may experience harm from the screening, including false positives leading to unnecessary tests and diagnoses of non-threatening issues.

In short, increased screening rates in the U.S. may have contributed to deteriorating health outcomes for men, as they pursued treatments for conditions detected through positive test results that were not life-threatening.

Despite a reduction in testing rates since their peak in the ’90s, prostate cancer mortality rates in the U.S. have gradually decreased over the years. This might be attributed to improved treatment protocols, rather than indicating benign prostate enlargement. Limiting trials to men who exhibit symptoms of prostate enlargement could prevent unnecessary cancer treatments.

In other regions, such as in Sweden, prostate cancer screening cut mortality rates from 1.7% to 0.98%, although this required diagnosing 13 men to prevent a single death.

What is the Solution?

To mitigate this issue and avoid unnecessary treatments, a “watchful waiting” approach has shown efficacy. A recent 15-year British study indicated that localized prostate cancer with low mortality rates whether treatment included radiation, prostate removal, hormone therapy, or observation. This underscores the futility of invasive treatments offering no significant benefits.

So, what steps can we take? In the UK, the National Screening Committee regularly reviews the recommendation for PSA screening for prostate cancer. Recent research has identified harmful cancers through MRI screenings, but there is still insufficient evidence regarding whether this can reduce death rates while minimizing excessive treatments.

Meanwhile, straightforward messages regarding the benefits of screening are being communicated to men without adequately addressing the potential drawbacks. Numerous screening events are organized by well-meaning charities during sports events. Advocates argue that informed consent is critical; otherwise, we risk offering false promises and ensuring minimal progress in men’s health.

This article was published in 2024

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Source: www.sciencefocus.com

Doctors say Biden’s prostate cancer diagnosis is unusual, but not unprecedented.

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New information regarding former President Joe Biden’s prostate cancer diagnosis indicates that while his case is not common, it is not entirely unheard of, according to the healthcare professionals who treated him.

At 82, Biden received a diagnosis of aggressive cancer on Friday after a nodule was found in his prostate, his personal staff announced. The cancer has spread to his bones, but his office stated that he is likely to respond well to treatment.

Most prostate cancer diagnoses occur at an early stage through routine screenings, which may include blood tests or rectal exams.

However, approximately 8% of cases have already metastasized to other organs by the time of diagnosis. In such instances, oncologists believe the patient may have had prostate cancer for several years, possibly up to a decade.

“We’ve encountered numerous patients facing significant health challenges,” stated Dr. William Dahoot, chief science officer at the American Cancer Society.

That said, exceptions exist.

“While most prostate cancers are slow-growing, some can develop rapidly and pose a high risk of metastasis,” explained Dr. Aron Weiser, a urologist and chief medical officer. “Is it common? No. But it can occur, dependent on the unique biology of that cancer.”

Screening facilitates early detection, yet there is disagreement among healthcare professionals regarding who should be screened for prostate cancer.

Many physicians refrain from screening men in their late 70s or 80s, as these individuals are generally more likely to die from other medical issues than prostate cancer. Nevertheless, with increasing life expectancies, some doctors consider screening appropriate for healthier older men.

According to the American Cancer Society’s recommendations, men in their 50s and 60s should be screened every two years. Men with elevated levels of prostate-specific antigens—a protein made by the prostate—should undergo annual screenings. Additionally, men at higher risk for prostate cancer, such as African Americans or those with a family history of the disease, should begin screening in their 40s.

However, current guidelines from the U.S. Task Force on Preventive Services, an independent panel that advises on practices often covered by insurance, state that men aged 55 to 69 should only consider discussing blood tests with their physicians. The task force is currently reviewing new screening guidelines for prostate cancer, with many healthcare providers advocating for a broader recommendation.

Weiser noted that there was a broader screening approach in the late 1980s and early 1990s, leading to premature diagnoses and treatments that may not have impacted patients’ lives. The 2012-2018 U.S. Preventive Services Task Force recommended blood tests to help identify prostate cancer, resulting in decreased screening rates.

“Prostate cancer behaves differently; many cases are benign, not causing issues for individuals,” Weiser remarked. “The goal should be to identify aggressive cancers.”

In recent years, there has been a shift back toward increased screening as doctors have improved their understanding of which cases require treatment versus those that should be monitored.

Nevertheless, Dahut expressed ongoing concerns among patients and physicians about whether the benefits of screening outweigh the risks of overdiagnosis and overtreatment. Screening rates have declined steadily since 2012, and Dahut notes that this trend has led to a 5% increase in diagnoses of more advanced prostate cancer.

It remains unclear whether Biden has undergone prostate cancer screenings in recent years. His annual physical examination in February 2024 did not indicate a screening was performed, which is not unusual for someone of his age. A physical exam in 2019 revealed an enlarged prostate but did not lead to a cancer diagnosis at that time.

Dr. David Shusterman, a urologist based in New York, stated that Biden’s advanced diagnosis is atypical among patients who are screened regularly.

“It is rare for metastasis to have occurred in someone who regularly sees a urologist,” he said.

Diagnosis is often more prevalent in individuals who do not maintain regular medical consultations. Rick Gum is one such case; he was never screened before his prostate cancer diagnosis in 2018. Gum, a 73-year-old trucking company owner from Big Rock, Illinois, initially sought care for a hernia but was found to have aggressive cancer that had spread to his bones.

“I learned the hard way,” he remarked. “I should have visited the doctor.”

Gum noted that his cancer was too advanced for standard treatment, prompting his participation in various clinical trials at Northwest Medicine, which included chemotherapy, radiotherapy, and treatments involving radioisotopes.

“I’ve enjoyed seven excellent years since my diagnosis,” he reflected. “They’ve been quality years. I ride motorcycles, travel a bit, and love my work. I’ve been able to do it all.”

According to the American Cancer Society, around 37% of patients with metastatic prostate cancer survive at least five years post-diagnosis.

Dr. Peter Nelson, vice president of precision oncology at the Fred Hutch Cancer Center, mentioned that patients like Biden could have over a 90% response rate to treatments that lower testosterone—a hormone that can promote cancer growth. These hormonal therapies are typically administered through injections or tablets.

“He may start with multiple medications and anticipate several years of effective treatment before any resistance develops,” Nelson noted. Some patients also receive chemotherapy or radiation in conjunction with hormone therapy, he added.

According to sources familiar with the family’s perspective, Biden and his family are exploring “multiple treatment options,” including hormone therapy.

Source: www.nbcnews.com

Approach to Prostate Cancer Diagnosis: Insights from Biden’s Patient Care Strategies

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Prostate cancer specialists assert that former President Joseph R. Biden’s diagnosis is grave. Announced by his team on Sunday, it was revealed that the cancer has metastasized to his bones and is classified as Stage 4, the most severe stage of the illness. This condition is currently incurable.

However, prostate cancer professionals highlight that advancements in the diagnosis and treatment of prostate cancer have significantly improved the outlook for men facing advanced disease, primarily based on research funded by the National Institutes of Health and the Department of Defense.

“We’ve explored numerous avenues for intervention,” remarked Daniel W. Lynn, a prostate cancer specialist at the University of Washington.

Dr. Judd Mull, a prostate cancer expert at Duke University, noted that men experiencing prostate cancer that has spread to the bones can now “survive five, seven, ten years or even longer” with current treatments. In the 1980s, men like Biden might “wish to pass away from natural causes rather than from prostate cancer,” he pointed out.

Biden’s office indicated that he experienced urinary symptoms, which prompted him to seek medical evaluation.

However, Dr. Lin expressed skepticism, stating, “I don’t believe his symptoms were related to the cancer.”

Instead, he suggested that the most plausible sequence was that doctors had examined Biden, discovered a nodule in his prostate, and conducted blood tests and prostate-specific antigen tests. PSA tests detect proteins produced by cancer cells and can follow blood tests and MRIs that indicate cancer.

Currently, Biden and other patients diagnosed with metastatic prostate cancer are in a better situation than past patients. There are approximately ten novel treatments available for the disease that have significantly altered the prognosis.

The primary strategy is to inhibit the testosterone that fuels prostate cancer. When Dr. Muru began his practice as a urologist in the 1980s, this was achieved by surgically removing the testicles. Today, men have the option of two medications administered via injection that prevent testosterone production, alongside oral pills that achieve the same result.

However, these medications alone are insufficient. Therefore, physicians typically add one of several androgen blockers that further suppress testosterone.

Some men receive supplementary treatments such as chemotherapy or radiation, depending on the extent to which the cancer might spread within the bones.

There have also been advancements in diagnostic procedures.

Previously, doctors assessed the degree of cancer in the bones through scans that detected inflammation. Now, they utilize a more precise scan known as the Prostate-Specific Membrane Antigen (PSMA) PET scan. This scan employs a radioactive tracer that binds to markers on the surface of prostate cells, allowing for faster cancer detection. Consequently, men with prostate cancer cells in their bones now often have a considerably better prognosis compared to those who underwent bone scans just a few years ago.

Additionally, there are medications available that block testosterone and others that can target cancer if chemotherapy and radiation therapy become ineffective.

Dr. Lynn pointed out that increased federal research funding, alongside Biden’s initiative to prioritize cancer research, has contributed to these advancements. He noted that Biden was “one of the first presidents to elevate cancer awareness.”

Regarding Dr. Muru, he remarked that men who develop stage 4 prostate cancer are now often filled with a sense of hope.

“There are now even more resources at our disposal,” Dr. Moul added. “The survival rate has nearly tripled in the last decade. The extent of change is truly remarkable.”

Source: www.nytimes.com

Can MRI scans improve the accuracy of prostate cancer screening?

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MRI scans may improve prostate cancer screening accuracy

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There is both good news and bad news when it comes to prostate cancer testing. First, the bad news. Blood tests that measure a compound called prostate-specific antigen (PSA) are too inaccurate. As a result, some men end up undergoing cancer treatments they didn’t actually need, causing incontinence and erectile dysfunction.

On the other hand, combining a PSA test with an MRI scan of the prostate can make screening more accurate, especially if double testing is recommended only for people at high risk of tumors. An expert group called the Lancet Committee on Prostate Cancer made this recommendation in a new report.

We certainly need to rethink prostate screening, but will these new proposals succeed in reducing harm?

Prostate testing has long been controversial. PSA is released at high levels by cancerous prostate cells, but is also produced at low levels by healthy prostate cells.

Blood tests were introduced as a way to track the success of cancer treatment. It began being used as a screening test in the 1990s, in part as a result of a campaign by men’s health groups for something comparable to breast cancer testing.

The problem is that PSA alone is not reliable as a screening tool. Levels may rise temporarily, such as after sex, during a urinary tract infection, or while riding a bicycle. Even if the increase continues, most prostate cancers grow so slowly that if left untreated, they will never be noticed or cause any problems.

These problems wouldn’t be so important if it weren’t for the fact that the treatments used to remove the cancer (usually surgery or injecting radioactive material into the tumor) can cause permanent incontinence and erectile dysfunction. It would have been. Biopsies to determine whether cancer is present can also cause these problems.

randomized trial It has been shown that for every 1,000 men who undergo regular PSA testing, one fewer man will die from prostate cancer over a 10-year period, but three will remain incontinent and 25 will remain impotent.

These disturbing figures are forcing health services in most high-income countries, including the UK and Australia, into uneasy compromises. Unlike breast and colorectal cancer tests, no invitations for prostate tests will be sent out, but those who wish to undergo the test can take it if the risks are explained to them.

As a result, higher-income men are more likely to take the PSA test, and lower-income and black men are less likely to be tested, the new report says. This is unfortunate because men of African descent are about twice as likely to develop prostate cancer as men of European descent.

The report’s authors say health systems need to use more sophisticated forms of screening, including both PSA tests and MRI scans. This scan allows your doctor to assess the size of your prostate and identify suspicious areas that may be cancerous.

Something close to this dual method is already in place in some countries, including the UK, where the next step for people found to have high PSA levels is an MRI scan. This means that people who are reassured by their scan results can avoid a more invasive biopsy. “This greatly reduces the problem of overdiagnosis,” he says. nicholas james, a researcher at the Institute of Cancer Research in London and one of the authors of the report.

But James says it may be even better to combine the PSA test with an MRI scan before the results are fed back to avoid men being mistakenly told they may have cancer.

The committee says health care organizations should use this combined approach to launch formal screening campaigns targeting three groups known to be at high risk. Black men, people with a family history of prostate cancer, and men who have a mutation in one of their prostate cancers. BRCA Genes also associated with breast cancer.

This would avoid the current situation where men at low risk are probably getting too many PSA tests, while men at high risk are getting too few or no PSA tests.

The proposal is certainly suggestive, but it remains to be seen whether it will discourage people from getting prostate exams. recently” cure cancer phobia.

The arrival of the PSA test may be like opening a Pandora’s box, James says, but the proposed new approach will likely alleviate at least some of the harm.

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Source: www.newscientist.com

Misconceptions about prostate cancer: What we need to know

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Recent news about King Charles’ prostate issues and subsequent cancer diagnosis has raised awareness of such health issues nationwide. Although the king is not diagnosed with prostate cancer, his efforts to raise awareness among older men have been widely appreciated.

The charity Prostate UK is using billboards to encourage men across the country to assess their cancer risk and consult their GP if they experience symptoms like frequent or difficult urination. However, prostate cancer is a complex and subtle condition.

The prostate, located below the bladder, tends to enlarge with age. The urethra, the tube draining urine from the bladder to the outside, passes through it. When the prostate enlarges, it can put pressure on the urethra, causing symptoms like dribbling and increased frequency of urination. This condition is quite common.

Similarly, prostate cancer is also common. Autopsy studies show that 36% of whites and 51% of African Americans develop prostate cancer in their 70s. There are even cases of prostate cancer found in 5% of men under 30 in autopsy studies. However, not all forms of prostate cancer are equally dangerous, with some being harmless and others potentially fatal.

How dangerous is prostate cancer?

Prostate cancer accounts for around 4% of male deaths in the UK, with approximately 12,000 people dying from it each year. The challenge lies in finding treatments that do not cause further harm, as treatments like surgery and radiation therapy can lead to side effects such as erectile dysfunction and incontinence.

The lack of an accurate way to differentiate between aggressive and non-aggressive tumors is a major problem. The PSA test, developed in the 90s, was introduced to monitor men’s response to prostate cancer treatment. However, the increasing number of diagnoses did not correspond to a reduction in mortality rates.

In the US, the Preventive Services Task Force has offered recommendations for or against PSA screening. While screening may slightly reduce prostate cancer deaths, it can also lead to unnecessary testing and treatments for non-fatal conditions.

To avoid unnecessary treatment, the “watchful waiting” approach has been effective in managing localized prostate cancer with low mortality rates. In the UK, the National Screening Committee does not recommend PSA screening for prostate cancer.

Research suggests that identifying harmful cancers through prostate screening MRI scans may be a viable solution, although more evidence is needed to assess its impact on reducing deaths without overtreatment.

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Source: www.sciencefocus.com