by Yulia Sudarikova
The Movember Foundation is the only charity which focuses entirely on the health of men worldwide. Through their awareness and fundraising projects, Movember deliver ground-breaking research and support programs, aiming to improve the quality and length of men’s lives. By 2030, they’ve committed to reducing the number of men dying prematurely by 25%, while also halving the number of deaths from prostate and testicular cancer.
Prostate cancer is the most commonly diagnosed cancer and the second largest cause of cancer-related deaths in UK men. Currently the only known risk factors include age, race, and family history1. These cannot be modified, so there is no evidence-based advice on prostate cancer prevention available for men. The Cancer Epidemiology Unit of the Medical Sciences Division at the University of Oxford has been actively involved in conducting research regarding disease detection and treatment. There are currently three main large-scale consortia of researchers focusing on the epidemiological studies of prostate cancer, which include the EPIC-Prostate consortium, the UK Biobank Prostate Cancer Epidemiology Consortium and the Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group.
The largest study2 of its kind was recently conducted as part of the Prostate testing for cancer and Treatment (ProtecT) trial, led by researchers at Universities of Oxford and Bristol in nine UK centres. The aim of the study was to compare active monitoring, radical prostatectomy (removal of the prostate), and external-beam radiotherapy as treatments of clinically localized prostate cancer. This ten-year-long study involved 1643 men, diagnosed through prostate-specific antigen (PSA) testing This blood test screens for the presence of a protein produced by both cancerous and healthy tissue in the prostate, so high levels of this antigen could help identify cancer or inflammation of the gland. Newly-diagnosed patients were split into three groups and the outcomes of treatments were compared, specifically in terms of prostate-cancer mortality after ten years of follow-up, as well as rates of disease progression, metastases and all-cause deaths. The study found that prostate-cancer-specific and all-cause mortality was low irrespective of the treatment, however more metastases and higher rates of disease progression were seen in the active-monitoring group. These findings can be useful for patients’ consideration of the short-term and long-term effects of radical treatments versus the higher risks of disease progression with the active-monitoring alternative.
Another case-study3, part of the ProtecT trial, aimed to detect causally relevant intervention targets, as well as non-causally associated biomarkers – molecules or genes which help identify a particular pathological process. These biomarkers can subsequently be used to develop risk prediction and disease detection methods. This study involved 2291 men screen-diagnosed with prostate cancer and 2661 controls, whose concentrations of 227 metabolites were measured using NMR spectroscopy. Nuclear magnetic resonance spectroscopy is a technique used to observe local magnetic fields around atomic nuclei, which helps identify the electronic structure and functional groups present within a particular molecule, whilst the intensity of the signal can indicate the molar concentration of the sample. Thirty-five metabolites were found to be strongly associated with prostate cancer, the majority of which were cholesterols, followed by glycerides and phospholipids. However, when fourteen of these were tested for causality, no evidence of a cause and effect relationship was seen. The findings of the study promise to be useful clinically, as the association found between biomarkers and disease may be used to better identify the presence and severity of prostate cancer.
Both studies were funded by the National Institute for Health Research (NIHR) and show promising results in contributing to the development of effective, as well as minimally invasive, detection and treatment strategies for prostate cancer.
Another way in which Oxford University has contributed to prostate cancer prevention efforts is through fundraising for the Movember foundation. The Movember appeal is a month-long campaign which involves growing a moustache in order to improve awareness and raise funds to contribute towards research funding and support projects for patients diagnosed with prostate cancer in the UK. Last year students at Oxford University managed to raise over £12,000 and this year’s campaign is currently underway, with events such as cuppers and tribute parties organised to step up Oxford’s fundraising efforts. All students are encouraged to join their college’s ‘team’ on the Oxford Movember page at uk.movember.com or follow the progress on https://www.facebook.com/oxfordmovember/
1 Huang J, Mondul A M, Weinstein S J, et al. September 2016, “Serum metabolomic profiling of prostate cancer risk in the prostate, lung, colorectal, and ovarian cancer screening trial.”Br J Cancer.
2 Hamdy F C, Donovan J L, Lane J A, Mason M, et al. September 2016, “10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.”N Engl J Med.
3 Adams C, Richmond R C, Santos Ferreira D L, et al. 23 October 2018, “Circulating Metabolic Biomarkers of Screen-Detected Prostate Cancer in the ProtecT Study.”Cancer Epidemiology, Biomarkers & Prevention.