UMGCCC Research: Improving Treatment for Prostate Cancer
Part of the University of Maryland Greenebaum Comprehensive Cancer Center’s mission is to find new and better ways of preventing, diagnosing and treating cancer. Many of UMGCCC’s physicians are actively involved in cancer research, and their findings are benefiting not only our patients, but potentially those all over the world.
Here are some examples of how UMGCCC’s university-based medicine is enhancing the ways we treat prostate cancer:
- What if there were a better prostate biopsy so that more high risk cancers were found and low risk tumors – which often lead to unnecessary treatment – were missed? That’s the question urologist Dr. M. Minhaj Siddiqui is seeking to answer. In a standard biopsy, a series of twelve tissue samples are taken from the prostate in a grid-like pattern. But that’s a bit like playing a game of Battleship … E5? Miss.
However, by combining ultrasound and MRI imaging during the biopsy procedure, Dr. Siddiqui is able to see the suspicious areas in the prostate and take samples from only there. He’s also working with researchers in the University of Maryland Department of Diagnostic Radiology to study next-generation imaging techniques that show tumor cell metabolism. Areas of high metabolism usually indicate cancer, so these images can lead to more accurate diagnoses.
- Which is the best initial way to treat high risk prostate cancer – surgery or radiation therapy? A team of UMGCCC researchers, led by radiation oncologist Dr. Adeel Kaiser, analyzed data from a group of more than 14,000 prostate cancer patients to find out. The patients studied were all under age 60 (so they would be less likely to die from natural causes) and had been treated in medical centers across the country from 2004 – 2013. The data showed that the 8-year estimated survival rate for patients who had had surgery (a complete removal of the prostate) was about 85% compared with 75% who had received radiation therapy.
The team concluded that starting with surgery results in better overall survival. However, the reasons why are likely complex. Patients who have had their tumors surgically removed also have them studied under a microscope – which could cause their doctors to recommend further treatment. About 17% of the patients who had surgery also had follow-up radiation therapy, which could be why they had improved survival rates. The team is looking further into the question.
- The growth of most prostate cancer tumors is driven by testosterone, the “male” hormone. Prostate cancer cells have ports called androgen receptors. When a testosterone molecule docks in one of these ports, it triggers a process that causes the cell to divide. But rather than destroying the cell, this creates two new cells, which in turn can divide again into four, eight, 16 and so on.
A team of researchers at UMGCCC, including Dr. Arif Hussain, Dr. Vincent Njar, Dr. Jianfei Qi, Dr. Hancai Dan, Dr. Yun Qui and others, are on the forefront of developing new ways of targeting androgen receptor ports. By destroying these ports, testosterone cannot reach cancer cells, and they stop dividing. Building on UMGCCC’s pioneering work in targeting estrogen receptors on breast cancer cells (see Dr. Angela Brodie), the team is creating new drugs that may prove to be effective for patients who no longer respond to hormonal therapies that lower testosterone.