Prostate cancer is five different diseases, say British researchers who suggest the ability to distinguish between the different types can help doctors in the future more effectively treat cases.
Scientists at Cancer Research UK Cambridge Institute, analyzing healthy and cancerous prostate tissue taken from more than 250 men, were able to group prostate cancer tumors into five distinct types, each displaying a characteristic and identifiable genetic fingerprint.
That could allow doctors to predict which prostate cancers are most likely to grow and spread aggressively in the body, the researchers say.
"These findings could help doctors decide on the best course of treatment for each individual patient, based on the characteristics of their tumor," says study author Dr. Alastair Lamb.
Some prostate cancers grow extremely slowly and present little risk to a patient, while others grow rapidly and spread aggressively, and current tests, such as the prostate-specific antigen (PSA) test, cannot reliably distinguish between them, researchers say.
In comparison, a small subset of the 100 genes associated with prostate cancer were better predictors of poor prognosis than any current method used in clinical settings, the researchers report in the journal EBioMedicine.
Those less-than-precise current methods mean that some patients may be receiving treatment or undergoing surgeries they don't need, while some other men who might benefit from more intensive treatment aren't getting them, they say.
That's what makes the ability to identify particular types of prostate cancer and their possible level of aggressiveness so important, experts say.
"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," says prostate cancer expert Malcom Mason at Cancer Research UK.
In the United States, prostate cancer is the most common nonskin cancer and the second-leading cause of cancer death among white, Hispanic and African-American men.
There will be 220,800 new cases of prostate cancer leading to 27,540 deaths this year, the American Cancer Society predicts.
The recent U.K. study, done in cooperation with Addenbrooke's Hospital in Cambridge, suggests more extensive research could yield even more precise knowledge of the molecular "nuts and bolts" of each prostate cancer type, Lamb says.
"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 says.
