Prostate cancer is the most common form of cancer to affect men, with 52,000 cases diagnosed in the UK per year. The majority of patients have slow growing cancers, but some patients have aggressive disease and require urgent treatment.
Current diagnostic tests, such as the PSA blood test, are not sufficient and early identification of those patients with aggressive disease remains a major challenge. Accurate diagnosis often requires an invasive biopsy which has many associated risks, including potential impotency and incontinence. There remains an unmet need for a non-invasive means of early identification of patients with aggressive prostate cancer, with the potential to limit the need for invasive biopsy, therefore improving the lives of patients with prostate cancer.
To address this challenge, Dr Jason Webber and his team at Swansea University's Medical School have been studying the mechanisms associated with prostate cancer progression. It is widely understood that the tumour microenvironment is complex, and communication between the key players is fundamental to the pathological processes associated with tumour growth and disease progression.
One aspect that is rapidly gaining interest is the role of extracellular vesicles (EVs). EVs carry many of the cargoes associated with the cell of origin and can therefore be said to act as a miniature representation of the cell. Importantly, researchers have shown that these EVs can pass through tissues, cross biological barriers, and enter the circulatory system. EVs are therefore present in biological fluids such as blood and urine. We are therefore developing several assays that can detect prostate cancer EVs, either in patient blood or urine. At present, we have two assays focussing on detection of specific genetic material (RNA) contained within EVs, or sugars (glycosaminoglycans) present on the EV surface.
With prostate cancer being a disease that impacts men globally, the team are collaborating with researchers locally (Cardiff), nationally (Newcastle, Nottingham and London) and internationally (Spain, Netherlands and Finland) to tackle the challenges of prostate cancer diagnosis. They also work very closely with the NHS, collaborating with several health boards, allowing us to test our assays on genuine patient samples.
Due to the importance of this research, Dr Webber and his team have received support from several funders including Prostate Cancer UK, Cancer Research Wales and Cancer Research UK.
Results from the team's assays are very promising, showing that they are capable of predicting the outcome of biopsy with greater accuracy than the current PSA blood test.
Dr Webber and his team are now testing their assays on larger cohorts of patient samples. These assays could readily sit alongside existing tests used for prostate cancer diagnosis, providing additional information to both the patient and clinical team to help inform decisions relating to management of disease. Importantly, these assays only require a small sample (less than a teaspoon) of blood or urine so they are non-invasive and, if needed, can be regularly repeated throughout the care process – with no risk to the patient.
By limiting the need for biopsy the team hope to improve the lives of all men undergoing diagnostic testing for prostate cancer. Since the tests are non-invasive there is no associated recovery time – unlike biopsy, which is a surgical procedure, requiring patients and/or family members/carers to take time either away from work or other pursuits.