Would you ever guess that urine might hold the key to better prostate cancer treatments? Dr. Bharati Bapat, a cancer geneticist at Mount Sinai Hospital in Toronto, is doing just that: Using patients’ urine to predict who is likely to develop different types of prostate cancer.

“There are currently no established approaches for Canadian doctors to distinguish between patients with slow growing versus aggressive disease,” says Dr. Bapat. “PSA and biopsies give us part of the story, but making treatment decisions can be difficult. We still need more information to understand if a patient’s cancer will progress.”

While there is room for improvement, researchers have found more and effective ways to treat prostate cancer, and designed better tests to detect it early in recent years. In fact, in the 25 years since Prostate Cancer Canada’s inception, the mortality rate from prostate cancer has decreased by 50 per cent. The major challenge still to overcome is that many patients are over-treated.
 

Overcoming patient anxiety and improving care

“When faced with a prostate cancer diagnosis, men and their families can feel considerable anxiety, especially when it comes to their treatment options,” says Dr. Bapat. “Many patients choose active surveillance involving regular biopsies, which have their own complications to consider. Conversely, some men initially diagnosed with slow-growing prostate cancer actually harbour aggressive prostate cancer cells that ultimately spread.”

“I want my research in genetics to help address this anxiety. Specifically, how can we use genetic information to develop better tools for early and accurate diagnosis, as well as monitoring the disease?”

Dr. Bapat used leading-edge, gene interrogation to pinpoint biomarkers in the urine and tumours of men with prostate cancer. These exciting discoveries led to the foundation for developing a test that looks for the biomarkers to predict which men have low-risk prostate cancer, and those with cancer that is likely to spread.

This new way to recognize how different prostate cancers will evolve could help doctors across Canada. With this knowledge for each patient, they could devise treatment and monitoring strategies catered specifically to individual men.

 “This research will ensure men and their doctors know immediately after diagnosis whether they require more invasive treatment or if they can be safely monitored without treatment.”

Dr. Bapat and her research team

A discovery 12 years in the making

Dr. Bapat has been researching prostate cancer for more than 12 years. Her interest and curiosity in how genes affect cell behaviour led to a desire to help the one in seven men who will be diagnosed with prostate cancer in their lifetime, as well as their families.

“Donations from Prostate Cancer Canada supporters have been instrumental in making these discoveries,” says Dr. Bapat. “Along with support from Movember Foundation’s donors, these contributions have moved the dial on our ‘bench to bedside’ research, ultimately leading to better patient care.”