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Re: Re: A Test to Differentiate Between Types of PCa?
My story is listed under Proton Therapy. I'm scheduled to start at Loma Linda in two weeks. I'm still planning to go ahead with the treatment, but it's interesting to think that possibly in 5, 10, or 20 years from now medicine may conclude that many of the treatments we are undergoing today for PCa were not necessary.
I remember back in my younger years it was fashionable for every kid to have a tonsillectomy because the docs insisted to our parents that it was necessary. And don't even get me started on the bizarre practice of circumcision we continue to perform on newborn males in the US to this day. Both are medical procedures which are now considered mostly unnecessary in light of current medical information. Perhaps if we have more information about specific strands of PCa in the future many of the modalities we choose currently will also become unnecessary. I know it doesn’t help most of us reading this board today, but hopefully our sons and grandsons will benefit from these breakthroughs.
Re: Re: Re: A Test to Differentiate Between Types of PCa?
I'm confused about determining whether the cancer is aggressive or not. I thought the biopsy led to a Gleason score for the cancer found, that that Gleason score was an indicator of cancer aggressiveness or non-aggressiveness.
As I understand it from Dr. Peter Scardino's book (The Prostate Book) how much the cancer cells differ from the normal cell was the indicator of aggressiveness of the cancer. If the cancer cell is close to normal in shape, it is a non-aggressive cancer. If the cell is wild and very odd shaped, it is the aggressive form of cancer. The Gleason sum is low for the non-aggressive, near-normal cell and the Gleason sum is high for the wild cells, thus indicating aggresiveness.
Now we have a possible finding that a chemical is present in aggressive cancers. Why do we need a test for this chemical when we have the Gleason score measuring how differentiated the cancer cells are?
Just on pathology alone there are 18 variant types of PCa they are not all the same categorically. Then within DNA pathology you have polidy test that can reveal which type of 3 polidities you might have, the first one resembles closer to normal cells and is better suited for hormone manipulations. The second and especially the third type of ploidity are said to be less controlled via hormone therapies, therefore should be probably considered a higher risks or prognostic consideration. Ploidity testing might cost $350-500 additional in pathology lab work, insurance might cover it.
This goes perhaps a little along with this thread but not the same message.
1. There is a "suggestion" that the measurement of sarcosine MIGHT aid in diagnosis HHMI investigator Arul Chinnaiyan and colleagues at the University of Michigan showed that as prostate cancer develops and progresses, sarcosine levels increase in both tumor cells and urine samples, suggesting that measurements of the metabolite could aid in non-invasively diagnosing the disease. Researchers might also be able to inhibit prostate cancer's spread by designing drugs that manipulate the sarcosine pathway.
2. Then there is this statement "This is proof-of-principle that we can identify metabolites, or panels of metabolites, that might be correlated with aggressive prostate cancer versus slower-growing prostate cancer," Chinnaiyan said. that again uses the 'might' word.
3. After that comes this The results suggest that drugs that alter sarcosine metabolism might be useful in treating prostate cancer, but Chinnaiyan cautions that these Petri-dish findings still need further validation in animal models. another suggestion that altering sarcosine 'might' be useful - but it is a loooong way from mice to men, let alone from petri dishes to men.
4. And finally For reliable diagnosis of aggressive disease, he said, "we need to have panels, not just rely on a single metabolite."
The Time report that Ron Hoffman linked to in his post is a bit more accurate in that it quotes the reaearchers clearly indicating that this is a possibility, no where near a certainty.
All of which doesn't, to me, justify the headline or opening paragraph in the BBC report:
New Prostate Cancer Marker In Urine Indicates Whether Cancer Is Spreading
ScienceDaily (Feb. 12, 2009) — Howard Hughes Medical Institute researchers have identified a new biological marker present in the urine of patients with prostate cancer that indicates whether the cancer is progressing and spreading.
But then maybe that's because I've see this all before.
