Prostate (prostate) cancer

Main article: Cancer (cancer)

Incidence

Prostate cancer (PC) ranks second in the incidence of all malignancies in men. In Russia, 44,706 new cases of this disease were diagnosed in 2019. In 2019, among all patients diagnosed with PCa, 39.4% were patients with stage III-IV, whose treatment requires the use of combination and complex therapy, including hormone therapy.

PCa is the fifth most common cause of death in the male population from cancer in Russia. In 2018, 13,007 people died from this disease ^[1]

Screening

From the age of 50, prostate cancer screening is recommended for all men. It is enough to take a blood test for PSA (prostatic specific antigen) 1 once every 1-2 years. PSA is a protein that releases prostate tissue. By the level of PSA, you can understand whether additional examinations are needed.

2023

New treatment for aggressive prostate cancer developed with 87.3% efficacy

On October 19, 2023, an international team of scientists proposed a new combined treatment for prostate cancer patients at high risk of biochemical recurrence. We are talking about the use of enzalutamide in combination with androgen deprivation therapy (ADT) Leuprolide.

In patients in the group in question, the standard treatment is based on ADT to suppress testosterone, which would otherwise stimulate the growth of cancer cells. However, enzalutamide, an oral inhibitor of androgen receptors, shows benefits in patients with metastases. Researchers from universities and cancer centers in the United States, Canada, Brazil, South Korea, Australia, Spain, France, Britain, Scotland and Finland have found that a combination of the two methods can give a more effective result.

Team of scientists propose new combined treatment for prostate cancer patients at high risk of biochemical recurrence

1,068 men with prostate malignancy and a high risk of biochemical recurrence were selected for the study. They were divided into three groups of approximately the same numbers. Men in the first group received combination therapy (enzalutamide 160 mg daily plus Leuprolide every 12 weeks), in the second - androgen-deprivation therapy with placebo, in the third - enzalutamide monotherapy.

Five years later, metastasis-free survival was found to be 87.3% in the combination group. In the second and third groups, this figure was recorded at 71.4% and 80%, respectively. No new adverse events were identified with combination therapy. In addition, no significant differences were found between the groups in quality of life measures. It is assumed that the results of the study will help increase the effectiveness of treatment of one of the most common types of malignancies.^[2]

Robot surgeon out to treat prostate tumours

On September 12, 2023, the American company Procept BioRobotics announced the development of the Aquablation robotic surgical system for the treatment of prostate tumors. Read more here.

Presented device for the treatment of prostate and kidney cancer with water vapor technology

On August 1, 2023, Francis Medical, a private company specializing in the production of medical equipment, introduced the Vanquish device for the treatment of prostate, kidney and bladder cancer through water vapor. Read more here.

2022

New 'electronic nose' sniffs urine at prostate cancer detection

In early December 2022, it became known about the creation of the Diag-Nose system, designed to detect biomarkers of prostate cancer in the urine. This technology, created by the Milan Polytechnic University, was a continuation of previous research, during which it was found that trained sniffer dogs can accurately detect prostate cancer. Read more here.

Developed a new method of treating resistant prostate cancer

In early November 2022, researchers at Cedars-Sinai Cancer Center identified a therapeutic approach that could be effective in combating treatment-resistant prostate cancer.

Cancer of the prostate, a small gland just below the bladder, is the second leading cause of cancer death in men. Many prostate tumors are not aggressive and may not require treatment or require minimal volume. Aggressive tumors are initially treated with surgery or radiation therapy.

New treatment for resistant prostate cancer emerges

In research with human cells and laboratory mice, the first author of the study, laboratory scientist Bethany Smith, found out that cancer cells signal the surrounding support cells through a protein called CD105 to produce these splice variants of proteins. The scientists then conducted a patient trial to test a drug they hoped would inhibit the formation of these partial proteins by inhibiting CD105.

In the trial, nine patients whose tumors were resistant to androgen-blocking therapy continued treatment but were also prescribed a CD105 inhibitor called carotuximab. 40% of these patients experienced non-progressive survival based on radiographs. According to the researchers, carotuximab also prevents androgen receptor splicing variants in the supporting cells surrounding the tumor, further increasing the tumor's sensitivity to the androgen suppressor.

Study co-author Sungyong Yu, director of the Urological Oncology Bioinformatics Group, identified three biomarkers that could help identify which patients would respond to this therapy. Going forward, the team will test these markers in a new clinical trial. The study was supported by Department of Defense Grant No. W81XWH-17-1-0154 and Veterans Administration Grant No. I01BX001040. According to Cedars-Sinai Cancer Center researcher Neil Bhoumika, this will allow future research aimed at patients most likely to benefit from this intervention.^[3]

Russia has created a way to detect prostate cancer by analyzing seminal fluid

Scientists at Sechenov University have found a new way to detect prostate cancer by conducting a study that relies on the analysis of seminal fluid through the isolation of tumor cells. The university told about this at the end of September 2022.

According to a researcher at the Laboratory of Directed Drug Transport at the Institute of Translational Medicine and Biotechnology at Sechenov University of Aleksei Rzhevsky, tumor cells released from the primary tumor can enter the ducts of the prostate and accumulate in prostatic fluid. In turn, seminal fluid, naturally rich in prostatic fluid, can be an excellent material for diagnosing prostate cancer.

In the Russian Federation, created a way to detect prostate cancer by analyzing seminal fluid

The technology created by the researchers for isolating tumor cells from seminal fluid is based on an innovative method of inertial microfluidics. This technology demonstrates excellent results for the isolation of tumor cells from the urine and blood of cancer patients. However, to isolate tumor cells from seminal fluid of patients with early localized prostate cancer was used for the first time. The trials involved 15 patients with diagnosed cancer at its early localized stage and 15 healthy men under the age of 30 as controls.

According to the findings, the method demonstrated significant potential as a promising alternative to existing conventional methods for diagnosing and predicting prostate cancer. In addition, the developed technique can potentially be used to isolate tumor cells not only in prostate cancer, but also in adenocarcinoma and testicular cancer.^[4]

Milk raises prostate cancer risk by 25%

Men with higher consumption of dairy products, especially milk, are at significantly higher risk of developing prostate cancer compared to men with lower consumption. This is stated in a study conducted by researchers from Loma Linda University and published in June 2022.

The study found no similar links between increased prostate cancer risk and non-dairy calcium intake, suggesting that substances other than calcium play a role in dairy-related prostate cancer risk.

Milk raises prostate cancer risk by 25%

The results of the study showed that men who consumed about 430 grams of dairy products per day (1 ¾ cup of milk) had a 25% increased risk of developing prostate cancer compared to men who consumed only 20.2 grams of dairy products per day (1/2 cup of milk per week). In addition, men who consumed about 430 grams of dairy products per day had an even greater risk than men with zero dairy consumption in their diet.

The study assessed the consumption of dietary foods of more than 28 thousand North American men with a wide range of effects of dairy products and calcium, all of whom initially did not have cancer. Dietary intake was assessed based on meal frequency questionnaires and repeated 24-hour analyses. The baseline questionnaire included demographic, family data history of prostate cancer, physical activity, alcohol consumption, prostate cancer screening, and body mass index.

The researchers then used state cancer registries to track the prostate cancer status of participants for an average of nearly eight years. By the end of the study period, state cancer registries reported 1,254 new cases of prostate cancer among participants during follow-up.^[5]

FMBA has developed a new method of treating prostate cancer

On March 22, 2022, the Federal Biomedical Agency (FMBA) of Russia announced the creation of a new method of treating prostate cancer. It was named "A Method of Focal Brachytherapy of Prostate Cancer in Patients Undergoing Low-Dose Intracanular Therapy." Read more here.

A radio hybrid indicator has been created that shows prostate cancer better than CT

On January 6, 2022, German researchers tested an experimental radiohybrid ligand of prostate-specific membrane antigen to elucidate its efficacy compared to conventional computed tomography in the background of metastatic prostate cancer. The scientific work was published in the European Journal of Nuclear Medicine and Molecular Imaging Journal of Nuclear Medicine.

Radiohybrid ligands are a class of radiopharmaceuticals that target a prostate-specific membrane antigen that is overexpressed in cancer cells. Hybrid ligands may be labeled with F-18 or radiometers such as gallium-68 or lutetium-177 for diagnostic and therapeutic use. The researchers found that a prostate-specific membrane antigen (rhPSMA) radiohybrid ligand labeled F-18 (F-18 rhPSMA-7.3) is good at identifying lymph nodes that need to be surgically removed and may be a more reliable clinical tool than contrast-enhanced computed tomography (CT) scans.

German researchers create radio hybrid indicator that shows prostate cancer better than CT scan

The most common radioactive indicator is fluorodeoxyglucose F-18, a glucose-like molecule. The F-18 PET rhPSMA-7.3 has shown positive results in early studies and is being evaluated in two phase III. trials as of January 2022. In the study, the scientists set themselves a goal for the first time in the real world to look at how this tracer works in the diagnosis of lymph nodes in patients during the primary staging of recurrent prostate cancer.

The group retrospectively identified 279 patients with primary prostate cancer who underwent CT scans with F-18 rhPSMA-7.3 between November 2018 and April 2020. A subset of patients underwent prostatectomy with lymph node excision without prior treatment. Patients underwent imaging on Siemens Healthineers' Biograph mCT Flow scanner.

After receiving the results, three certified nuclear medicine physicians with three to 10 years of experience first analyzed diagnostic images of contrast-enhanced CT, and then the F-18 dataset rhPSMA-7.3 at least four weeks later. Standard surgical fields were evaluated on a five-point scale independently for radiohybrid ligand and for contrast-enhanced CT, and the results were compared with histopathological data by patient. According to the results, the specificity and accuracy of determining metastases to pelvic nodes at the patient level were higher for radiohybrid ligands with F-18 rhPSMA-7.3 than for contrast-enhanced CT.

F-18 rhPSMA-7.3 PET provides superior diagnostic performance compared to morphological imaging for primary N-staging of newly diagnosed prostate cancer. F-18 rhPSMA-7.3 PET can significantly improve primary N-staging compared to conventional imaging, "said Thomas Langbein, a nuclear medicine physician at the Technical University of Munich.

As the scientists noted, the study provides real-world clinical data showing that F-18 rhPSMA-7.3 has moderately high sensitivity and specificity to detect lymph node metastases in patients with moderate to very high-risk prostate cancer. However, one of the well-documented limitations of targeted radio operators, such as the DCFPyL Ga-68 PSMA-11 and F-18, is high urinary retention and especially high accumulation in the bladder. In this study, F-18 rhPSMA-7.3 showed low urinary retention and high uptake by tumor lesions, resulting in a favorable tumor-bladder ratio, potentially increasing detection of local tumor deposits, especially at the prostate base, the researchers added.^[6]

2021

MRI system for prostate cancer sound waves released

In early December 2021, Insightec announced the launch of the Exablate Prostate platform, which uses proprietary directional sound wave technology to kill prostate cancer tissue in patients at low or medium risk. Read more here.

Russian scientists have developed a drug for the treatment of prostate cancer based on a substance from European yew needles

The Russian scientists developed a drug for the treatment of prostate cancer on the basis of a substance obtained from yew needles. the European This was announced on November 20, 2021. MISIS More. here

Announcement of AI system that detects prostate cancer during routine CT scans

In mid-July 2021, researchers from RMIT University in Melbourne (Australia) created an AI system that will be able to detect prostate cancer during standard computed tomography. Usually, it is difficult to detect prostate cancer in CT images, and pronounced radiation makes CT unsuitable as a screening method. However, if men undergo abdominal or pelvic scans for other reasons, the proposed system would detect prostate cancer and start treatment early.

There is no prostate cancer screening programme in Australia, but armed with this technology, we hope to detect early-stage cancer in patients who undergo scans for other reasons, one of the researchers explained.

AI system that detects prostate cancer during CT scans introduced

Prostate cancer remains a significant cause of cancer deaths in men. In Australia, where the technology was developed, prostate cancer is responsible for approximately 12% of cancer deaths in men. Although prostate cancer usually grows rather slowly, it often goes unnoticed for many years, which extremely reduces survival, because early onset remains the most important factor in the success of therapy. Men over 40 are advised to undergo routine prostate tests, but many miss such visits. While routine effectiveness screenings cannot be replaced, scientists hope the accidental detection of prostate cancer from CT scans will help many men who would not otherwise seek help for years to come.

Australian researchers trained their AI system on CT data from men with and without asymptomatic prostate cancer. As a result, the system has learned to quickly detect signs of malignant growth that are invisible to the human eye and finds cancer cases more accurate than radiologists.^[7]

2020

System for laser removal of cancerous tissues in prostate released

In mid-December 2020, software and medical equipment manufacturer Avenda Health released a focal laser ablation system for soft tissue removal. The solution, called Orion, features a patented laser needle and thermo-optical sensor to accurately target and evaluate soft tissues. Read more here.

New PET/CT method to diagnose prostate cancer emerges

At the end of October 2020, the researchers presented evidence that the PET/CT technique with PSMA (prostate specific membrane antigen) allows us to effectively differentiate localized and metastatic cases of high-risk prostate cancer (PC). In patients with PCa, the development of the disease may be due to hereditary mutations, as in the development of female tumors, as well as somatic mutations in homologous recombination genes (HRR genes) acquired by patients in the process of vital activity. Thus, HRR gene mutations occur in about 20-30% of patients with metastatic castration-resistant PC. Read more here.

2019

Philips has developed AI-based disease detection technology.

In early December 2019, Phillips announced that it had begun introducing AI-based prostate cancer detection technology developed by startup Paige AI into its equipment. Read more here

An increase in the incidence in Russia by 3 times in 5 years to 57 cases per 100 thousand population

Over the past 15 years, by 2019, the incidence rate in Russia has increased 3 times from 19.01 to 57.22 cases per 100 thousand population. The average annual rate of increase in incidence is 7.12%.

Global prostate cancer deaths decline

In early April 2019, researchers concluded that prostate cancer morbidity and mortality are declining in most countries of the world.

The group, led by MaryBeth Freeman of the American Cancer Society, examined data from the International Agency for Research on Cancer and found that the overall incidence of prostate cancer decreased or stabilized (that is, stopped growing) in 90.9% of 44 countries between 2008 and 2012.

Looking at WHO data, the researchers also found a reduction or stabilization in mortality in 95.8% of the 71 countries surveyed for prostate cancer deaths.

Analysis of these data also showed that the lowest incidence of prostate cancer is observed in India, Thailand and Bahrain, while the highest is in Brazil, Lithuania and Australia. The lowest mortality was in Thailand and Turkmenistan, and the highest in the Caribbean, South Africa, Lithuania, Estonia and Latvia.

In early April 2019, researchers concluded that prostate cancer morbidity and mortality are declining in most countries of the world

In addition, Freeman and her colleagues used the information to analyze long-term trends on a global scale. They found that between 1980 and 2012, the largest decline in prostate cancer occurred in the US, mainly due to the increased use of the prostate-specific antigen (PSA) test. In the US, the incidence of prostate cancer increased between the 1980s and the early 1990s, and then began to decline from the mid-2000s.

Freeman noted that PSA screening is not as accessible in low-income countries, and this restriction may have contributed to delayed diagnosis and increased mortality rates in those countries. Several countries also want to reduce the use of PSA screening due to concerns about possible overtreatment of prostate cancer.

Freeman concluded that patients should discuss the benefits and harms of PSA testing with their healthcare provider. Future studies, in turn, should assess the impact of PSA screening in several countries, tracking mortality trends and late-stage disease detection.^[8]

See also

• Cancer treatment
• Breast cancer (BC)
• Lung cancer
• Bladder cancer

Notes