DESNT: Poor Prognosis Prostate Cancer
Could unnecessary surgery soon be confined to (medical) history?
“There is currently no proper classification of prostate cancer,” says Colin Cooper, Professor of Cancer Genetics in Norwich Medical School at the University of East Anglia. “This is a major problem for people who are diagnosed with the disease, because only a small proportion is actually fatal. This leads to massive overtreatment – particularly in the USA, where many men are made impotent unnecessarily. We urgently need a test that can distinguish aggressive from non-aggressive cancers so treatments can be targeted.” The strong sentiment kick-started Cooper into co-leading a study to create a classification framework for prostate cancers (1).
During conventional prostate cancer diagnosis by blood test or rectal exam, categorization of the disease is difficult because of its highly heterogeneous nature. What if the problem were approached from a mathematical perspective instead of a purely medical one? The investigators used a Bayesian model – latent process decomposition – to analyze the transcriptomic data of prostatectomy patients. The model revealed 45 genes that show low levels of expression in what the researchers call “DESNT” prostate cancers – a subcategory with a poor prognosis.
Does this mean there’s a new prostate cancer diagnostic? Not according to Cooper. “Designation of a cancer as DESNT is not a biomarker. The category was identified before we linked it to clinical data and found it had poor prognosis. It is a new classification of prostate cancer.” He adds, “Much of the data that we used has been around for over 10 years. It’s just that the wrong math has been used to analyze the results. When you use the right math, it’s easy to see the DESNT poor-prognosis cancers.”
As for the classification’s future, the researchers plan to develop a test to identify DESNT cancers in the clinic. And Cooper’s lab is also setting up a review to determine how easily histopathologists can distinguish DESNT cancers from more benign ones. If implemented, proper classification could not only save resources in cases that don’t require treatment, but also save men from unnecessary pain and suffering.
- BA Luca et al., “DESNT: A Poor Prognosis Category of Human Prostate Cancer”, Eur Urol Focus, (2017).
My fascination with science, gaming, and writing led to my studying biology at university, while simultaneously working as an online games journalist. After university, I travelled across Europe, working on a novel and developing a game, before finding my way to Texere. As Associate Editor, I’m evolving my loves of science and writing, while continuing to pursue my passion for gaming and creative writing in a personal capacity.
