Gene discovery revolutionizes the detection and treatment of prostate cancer

Prostate cancer is the second most common cancer affecting men globally, with diagnostic methods and risk assessment remaining a challenge despite decades of research. For years, the prostate-specific antigen (PSA) blood test has been a cornerstone in detecting prostate cancer.

However, while PSA testing has been shown to reduce prostate cancer-related deaths, it also leads to over-diagnosis. This calls for a shift toward more individualized and informed approaches to screening, especially for younger men.

PSA’s biological role goes beyond its use as a diagnostic marker. It plays a critical role in liquefying semen and tumor progression by interacting with growth factors and proteins in the extracellular matrix. This activity promotes cancer cell migration, bone metastasis, and blood vessel formation in tumors.

Despite its clinical utility, PSA’s ability to distinguish between aggressive and indolent cancers remains limited. Recent advancements in genetics offer insights into this limitation and present opportunities for improved diagnostic methods.

Genome-wide association studies (GWAS) have identified more than 450 single nucleotide polymorphisms (SNPs) linked to prostate cancer risk. These SNPs account for approximately 42.6% of familial prostate cancer risk in individuals of European ancestry. Among them, a specific SNP in the KLK3 gene—which encodes PSA—has drawn significant attention.

Known as rs17632542, this SNP causes an amino acid substitution from isoleucine to threonine (Ile163Thr) in PSA. This genetic variation is associated with reduced prostate cancer risk, yet its precise role in the disease has remained unclear.

Recent research, published in the journal, Nature Communications, sheds light on how this SNP influences PSA’s biochemical activity and its implications for cancer progression. Laboratory and animal studies reveal that the Ile163Thr variant alters PSA’s proteolytic activity, impacting the tumor microenvironment.

This variant is linked to smaller primary tumors but higher metastatic potential, particularly to the bones, where it triggers pronounced bone loss. These findings highlight the dual nature of this genetic variation: while it reduces overall cancer risk, it paradoxically increases the likelihood of aggressive disease.

The SNP’s impact extends to PSA levels in the blood. Carriers of this variant typically exhibit lower total PSA and a higher free-to-total PSA ratio. This could lead to delayed prostate cancer diagnosis, as lower PSA levels might not trigger early biopsy recommendations. Consequently, some aggressive cancers may go undetected until later stages, resulting in worse outcomes.

“Through comprehensive lab and mice tests, we found that this SNP, although associated with reduced prostate cancer risk, is also associated with an aggressive type of this cancer,” said Dr. Srinivasan, one of the study’s lead researchers. She emphasized that the findings help explain anomalies in current diagnostic practices and underscore the need for improved screening tools.

Despite its limitations, the PSA test remains a vital diagnostic tool. However, it cannot differentiate between aggressive and non-aggressive cancers.

This limitation leads to over-diagnosis, over-treatment, and unnecessary biopsies, which impact patients’ quality of life and increase healthcare costs. At the same time, low PSA levels associated with aggressive cancers may result in delayed diagnosis and higher mortality.

Professor Jyotsna Batra, who spearheaded the study, highlighted the potential for personalized medicine to address these challenges. “Findings from this study may lead to developing a novel and simple point-of-care device,” she said.

Such a device could identify patients with genetic variations linked to aggressive prostate cancer, even when PSA levels are low. This would enable general practitioners to provide tailored diagnostic assessments and guide clinical decisions more effectively.

Collaborative efforts by researchers have advanced understanding of how genetic variations influence prostate cancer outcomes. The research team, led by Professor Batra and QUT Distinguished Professor Emeritus Judith Clements, included experts from bioinformatics, biomedical sciences, and clinical practice.

Their findings could revolutionize prognostic prediction by distinguishing more aggressive cancers and identifying high-risk groups who need early intervention.

This breakthrough research highlights the interplay between genetics and diagnostic markers like PSA. By identifying the functional implications of the rs17632542 SNP, scientists are paving the way for more accurate and individualized approaches to prostate cancer care. The study’s findings emphasize the importance of integrating genetic data into routine screening and treatment protocols.

As researchers continue to unravel the complexities of prostate cancer genetics, the goal of personalized medicine comes closer to reality. With tools informed by genetic variations, clinicians could one day offer more precise and effective care, reducing the burden of over-diagnosis while improving outcomes for those with aggressive disease.

This innovative approach aligns with an era of personalized treatment, where genetic insights transform how diseases like prostate cancer are managed.

Note: Materials provided above by The Brighter Side of News. Content may be edited for style and length.

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