THE “NEW” PROSTATE CANCER INFOLINK

According to a report in Clincial Cancer Research last Thursday, Spanish researchers may have found a way to tell whether some suspicious prostate lesions are likely to develop into actual prostate cancer. We emphasize the words “may” and “some.”

The study reports an apparent connection between high-grade prostatic intraepithelial neoplasia (HG-PIN) lesions and the PTOV1 gene. The more PTOV1 the lesion expresses, the more likely it is that cancer will develop. The report also backs the reverse — that the lack of PTOV1 means a reduced risk of prostate cancer.

We really don’t yet understand the function of the PTOV1 protein. We do know that too much of it appears to promote the spread of cancer cells, but that’s about the limit of our current knowledge.

Rosanna Paciucci, one of the study’s authors, said, “Those patients with a high PTOV1 score should undergo an immediate repeat biopsy.” She also suggested that patients with low PTOV1 scores may not need to receive future “annoying and useless” biopsies. “We estimate that we can save 40 percent of unnecessary biopsies — those that are repetitively negative and contain HG-PIN lesions that do not develop into cancer,” she said.

The “New” Prostate Cancer InfoLink agrees with Pacciuci and her colleagues that we need to see these data replicated in another another larger study before we rush to put this type of data into clinical practice, but it would certainly be helpful for men with a diagnosis of HG-PIN if they could get an early assessment of the clinical significance and risk of this diagnosis.

HG-PIN, while present in most cancerous prostates, is a pre-malignant lesion and, given its association with other cancers, it is currently recommended that repeat biopsies be carried out when it is found. (More information on PIN is available elsewhere on this site.) Past studies have put the average risk of cancer being diagnosed in a HG-PIN biopsy at between 20 and 30 percent, according to Paciucci. However, none of these studies were able to tell which lesions would progress to cancer.