Innovation in Cancer Detection

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One of our primary goals here at the International Prostate Cancer Foundation is to be on the forefront of both research and education. Which mean we are always looking to the newest innovations in prostate cancer research and treatment. This year there have been many strides made in cancer detection. These are just a few of some of the amazing advancements moving the cause forward.

Prostate cancer detection from urine RNA steps closer
(excerpts from: http://www.medicalnewstoday.com/articles/307845.php)

Testing for non-coding RNA molecules in urine may offer a way to detect prostate cancer that is more accurate and reliable than current methods using biomarkers such as PSA and PCA3.

This was the conclusion of a German study presented at the European Association of Urology Congress (EAU16) in Munich, Germany, March 11-15, 2016.

Friedemann Horn, a professor in the University of Leipzig and the Fraunhofer Institute for Cell Therapy and Immunology IZI, and Manfred Wirth, a professor in the University of Dresden – both in Germany – led the work.

Prof. Wirth says:

“Our work on RNAs [ribonucleic acid] is allowing us to design a completely new kind of prostate cancer test.”

Current biomarker tests for prostate cancer measure levels of PSA (prostate-specific antigen) and PCA3 (prostate cancer gene 3), but they are not particularly accurate and can either miss many cancers or produce false positives.

FDA approves new diagnostic imaging agent to detect recurrent prostate cancer
(excerpts from: http://www.medicalnewstoday.com/releases/310654.php )

The U.S. Food and Drug Administration has approved Axumin, a radioactive diagnostic agent for injection. Axumin is indicated for positron emission tomography (PET) imaging in men with suspected prostate cancer recurrence based on elevated prostate specific antigen (PSA) levels following prior treatment.

Prostate cancer is the second leading cause of death from cancer in U.S. men. In patients with suspected cancer recurrence after primary treatment, accurate staging is an important objective in improving management and outcomes.

“Imaging tests are not able to determine the location of the recurrent prostate cancer when the PSA is at very low levels,” said Libero Marzella, M.D., Ph.D., director of the Division of Medical Imaging Products in the FDA’s Center for Drug Evaluation and Research. “Axumin is shown to provide another accurate imaging approach for these patients.”

Two studies evaluated the safety and efficacy of Axumin for imaging prostate cancer in patients with recurrent disease. The first compared 105 Axumin scans in men with suspected recurrence of prostate cancer to the histopathology (the study of tissue changes caused by disease) obtained by prostate biopsy and by biopsies of suspicious imaged lesions. Radiologists onsite read the scans initially; subsequently, three independent radiologists read the same scans in a blinded study.

The second study evaluated the agreement between 96 Axumin and C11 choline (an approved PET scan imaging test) scans in patients with median PSA values of 1.44 ng/mL. Radiologists on-site read the scans, and the same three independent radiologists who read the scans in the first study read the Axumin scans in this second blinded study. The results of the independent scan readings were generally consistent with one another, and confirmed the results of the onsite scan readings. Both studies supported the safety and efficacy of Axumin for imaging prostate cancer in men with elevated PSA levels following prior treatment.

New device developed at UBC could improve cancer detection
(excerpts from: http://www.medicalnewstoday.com/releases/310195.php)

A new UBC-developed method to isolate cancer cells that have escaped from a tumour could soon pave the way for improved diagnosis and treatment.

The simple process involves a special device that squeezes cells in a blood sample through tiny funnels, which drive the cancer cells and blood cells into separate streams based on differences in their size and softness.

“Circulating tumour cells–cells from a tumour that have escaped into the bloodstream with the potential to spread into other tissues–are extremely useful for assessing a patient’s disease in order to select the most appropriate treatment,” said UBC mechanical engineering professor Hongshen Ma, the lead researcher. “These cells are particularly important for prostate cancer, where the site of metastasis is typically in the bone, where biopsies are difficult or impossible.”

Ma’s research focus is microfluidics, the flow of liquids through channels smaller than a human hair. The microfluidic device designed by his team captures cells based on their distinct internal structure–a mechanical analysis instead of the blood chemistry analysis used in conventional medical diagnostic techniques.

The device was first tested using blood samples spiked with cancer cells. It was then used to analyze blood samples from 20 patients with metastatic castration-resistant prostate cancer, an advanced form of cancer, and from four healthy individuals.

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Robot Technology Aids in Education

Dr Alejandro Granados from Imperial College London demonstrates the robotic rectum technology,.jpg

Dr Alejandro Granados from Imperial College London demonstrates
the robotic rectum technology

Excerpts from Medical News Today contained below.

Technology seems to be moving at lightening speed these days. From computers that fit in our hand, to robotic learning tools. It’s a progressive time in our history.  This past July, scientists at Imperial College London developed a prosthetic buttocks and rectum to help train doctors and nurses to perform prostate cancer exams.

The idea is the device helps train doctors and nurses to perform rectal examinations by accurately recreating the feel of a rectum, as well as providing feedback on their examination technique. The device contains small robotic arms that apply pressure to the silicone rectum, to recreate the shape and feel of the back passage.

Rectal examinations are necessary to diagnose conditions such as prostate cancer and involve a medic placing their index finger into the anus, and feeling the prostate gland.

 

Generally, cancerous prostates tend to feel hard and knobbly, but learning exactly what a potentially cancerous prostate feels like can be difficult, explains Dr Fernando Bello, from the Department of Surgery and Cancer at Imperial College London: “Internal examinations are really challenging to learn – and to teach. Because the examinations occur in the body, the trainer cannot see what the trainee is doing, and vice versa. In addition to this, medics rarely get the chance to practise the examination, as few patients would volunteer as practice subjects. In fact there is only one person registered in the country as a test subject, called a Rectal Teaching Assistant (RTA) in the UK.

“But the results of these examinations can have major implications for patients – they are very important for early diagnosis of various conditions such as prostate cancer.”

Although plastic models exist to help train medical staff, these do not feel like living flesh and tissue, added Dr Bello. Therefore to help doctors and nurses practice how to perform these examinations – and to ensure they are as comfortable as possible for patients, Dr Bello and his team have created a robotic ‘trainer rectum’.

When using the trainer, a doctor inserts his finger inside a silicone thimble attached to robotic technology able to recreate the exact sensation of the human rectum.

Furthermore, a computer screen behind the device can display a 3D model of the rectum and prostate, allowing the doctor, with the aid of 3D glasses, to see the anatomy while they perform the examination. The technology can be programmed for different scenarios, allowing the anatomy to be changed each time, explained Dr Alejandro Granados, also from the Department of Surgery and Cancer at Imperial and who is leading the development of the robotic rectum.

He added: “We have already asked a number of doctors and nurses – including prostate specialists and cancer surgeons – to trial the technology. They commented on the great advantage of being able to alter the anatomy. The size and shape of the rectum and prostate can vary greatly from person to person, and this technology enables medics to practice their skills in many different virtual patients. They also observed that because these examinations are performed solely by feel, experiencing a realistic sensation is crucial.”

Furthermore, the team are continuing to perfect the device, by collecting data from real prostate examinations in patients.

To read the full article at Medical News Today click here.

Prostate Cancer Research is the focus of the Journal of Molecular Diagnostic in November

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We are always happy to see Prostate Cancer Research make it into the public forum. And this month we are proud to say our board member Ranjan J. Perera, is leading groundbreaking research in Putative Biomarkers for Prostate Cancer Detection. IPCF is proud to say, last year we awarded a grant to the Sanford-Burnham Institute for Medical Research, which resulted in this landmark research for prostate cancer biomarkers.

Prostate cancer is the leading cause of cancer and the second leading cause of cancer related death in males. While much work has been done in the realm of prostate cancer diagnosis there is still no agreement on a single diagnostic marker to be used for definitive diagnosis. Markers that are frequently used as diagnostic tools of prostate cancer include PSA and PCA3. Both markers however have limitations. PSA may lead to certain confusing situations when some other diseases such as inflammation (prostatitis) or benign prostate hyperplasia can provoke the same degree of PSA changes.  PCA3 as a urine marker was recently introduced in wide clinical practice. Although it is proven to exclude prostate cancer, the overall value of this test is limited to predict aggressive nature of the disease. This leaves room for improvement in the detection of prostate cancer.

In this collaborative study done at the Sanford-Burnham Medical Research Institute and Global Robotics Institute six main genes are searched in as a potential diagnostic tools to improve the diagnosis and risk stratification of prostate cancer. These are small molecules of RNA (ribonucleotide acids) that can play a crucial role in cancer development and progression. These molecules can be found in prostate tissue as well as in urine or blood.

The study consisted of 3 parts. The first one compared the level of this molecular gene information between healthy versus cancerous prostate tissue from laboratory-produced prostate cancer cells. The second analysis included a comparative measurement of these molecules from biopsy tissue of patients with and without prostate cancer. The third one performed an analysis of urine samples for these molecules between normal and cancerous patients. What was found was that these RNA structures were found in significantly increased levels in all cancer groups in comparison to the non-cancerous groups.

The initial results of this study demonstrated the promising value of newly discovered gene molecules as additional diagnostic tools that can be detected in tissue, blood and urine.  We can combine the use of these markers with additional parameters such as PSA and PCA3 to increase the accuracy of diagnosing prostate cancer. Additional studies may be carried out to further evaluate the utility of these markers.

To download the full article click here, and download from the right hand side of the page.