Prostate cancer treatment praised

Australia and New Zealand are among the best places in the world to be diagnosed with prostate cancer, according to a visiting US professor who says aggressive treatment is being avoided in many cases.

In many countries, a diagnosis of prostate cancer almost always leads to removal or radiation therapy. In Australia and New Zealand, however, many low-risk patients are being managed by active surveillance.This means they are monitored with regular blood tests, biopsies and MRIs and aggressive action is taken only if the disease becomes life-threatening. Visiting American professor James Eastham, who will address urologists at a conference in Melbourne on Monday, is full of praise for his colleagues in Australia and New Zealand. He says about one in three men who are newly diagnosed with prostate cancer are candidates for active surveillance. In Australia and New Zealand, about half of these are managed with active surveillance. This is well ahead of the US, where only about 10 per cent of eligible patients are managed by active surveillance. This leads to over-treatment. ‘I’m impressed. This is not the traditional way of treating cancer,’ said Prof Eastham, from the Memorial Sloan Kettering Cancer Centre in New York. He will reassure the annual scientific meeting of the Urological Society of Australia and New Zealand that the latest research from around the world suggests active surveillance is a safe and effective way to manage patients. ‘It maximises quality of life without compromising quantity of life.’ Prof Eastham also agrees with the society’s position on screening men at the age of 40. ‘We know testing saves lives,’ he says.

Chemotherapy can boost cancer – study

Cancer-busting chemotherapy can cause damage to healthy cells that triggers them to secrete a protein that sustains tumour growth and resistance to further treatment, a study says. Researchers in the US made the ‘completely unexpected’ finding while seeking to explain why cancer cells are so resilient inside the human body when they are easy to kill in the lab. They tested the effects of a type of chemotherapy on tissue collected from men with prostate cancer, and found ‘evidence of DNA damage’ in healthy cells after treatment, the scientists wrote in Nature Medicine. Chemotherapy works by inhibiting reproduction of fast-dividing cells such as those found in tumours.

The scientists found that healthy cells damaged by chemotherapy secreted more of a protein called WNT16B, which boosts cancer cell survival. ‘The increase in WNT16B was completely unexpected,’ study co-author Peter Nelson of the Fred Hutchinson Cancer Research Center in Seattle told AFP. The protein was taken up by tumour cells neighbouring the damaged cells. ‘WNT16B, when secreted, would interact with nearby tumour cells and cause them to grow, invade, and importantly, resist subsequent therapy,’ said Nelson.

In cancer treatment, tumours often respond well initially, followed by rapid regrowth and then resistance to further chemotherapy. Rates of tumour cell reproduction have been shown to accelerate between treatments. ‘Our results indicate that damage responses in benign cells… may directly contribute to enhanced tumour growth kinetics,’ wrote the team. The researchers said they confirmed their findings with breast and ovarian cancer tumours.

The result paves the way for research into new, improved treatment, said Nelson. ‘For example, an antibody to WNT16B, given with chemotherapy, may improve responses (kill more tumour cells),’ he said in an email exchange. ‘Alternatively, it may be possible to use smaller, less toxic doses of therapy.’