Biomarkers May Predict Aggressiveness of Prostate Cancer

Cancer expert is wary of finding, however

By Ed Edelson
HealthDay Reporter

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TUESDAY, May 5 (HealthDay News) --Three molecules associated with prostate cancer might provide the long-sought markers that could discern which tumors are life-threatening and need aggressive treatment, a new study indicates.

The currently hot debate about the value of screening for early detection of prostate cancer hinges on the fact that the cancer is usually so slow-growing that there is no lifesaving benefit from treatment such as surgery, which can cause impotence and incontinence. Recent studies in the United States and Europe found at best limited benefit from routine prostate cancer screening, and new guidelines from the American Urological Association say that many men do not need annual screening tests.

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As yet, there are no established markers to distinguish which prostate cancers grow fast enough to require such treatment. The new study, published in the May 5 issue of the Annals of Internal Medicine, identifies three such markers.

"We're not trying to say these are the only markers," said study author Dr. John Concato, a professor of medicine at Yale University and director of the clinical epidemiological research for the Veterans Affairs Connecticut Healthcare System. "This is a proof of principle."

Measuring levels of the markers might someday help guide treatment of men with prostate cancer, he said. "If the markers are positive, that might be an indication that more aggressive therapy is indicated," Concato said.

However, that claim was challenged in an accompanying editorial by a cancer specialist.

The findings stemmed from an examination of tissue samples from 1,172 men diagnosed with prostate cancer at VA centers in New England. Researchers looked at a number of possible biomarkers and identified three associated with a higher risk of death from the cancer: bcl-2, a molecule that helps regulate cell death; p53, a protein produced by a tumor-suppressor gene; and microvessel density, the excessive production of blood vessels needed for growth of a cancer.

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