They discover bacteria in the urine that could predict the risk of aggressive prostate cancer

A study by the University of East Anglia in the United Kingdom opens the door to a new type of screening. The importance of early diagnosis of the most aggressive tumors, according to experts from Colombia and Mexico

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06/07/2018 Células en el cáncer de próstata
SALUD
IMPERIAL COLLEGE LONDON
06/07/2018 Células en el cáncer de próstata SALUD IMPERIAL COLLEGE LONDON

A scientific team from the University of East Anglia, in the United Kingdom, identified in the urine of a group of men a number of bacteria that are linked to a very aggressive type of prostate cancer. Research opens the door to developing a new type of detection of serious tumors with a urinalysis. The work was published in the journal European Urology Oncology.

According to the study, experts analyzed more than 600 patients with and without prostate cancer, to evaluate the usefulness of a bacterial urine test. This allowed them to identify 5 types of bacteria that repeated in different samples and tissue from men with cancer types that later became aggressive.

These are bacteria capable of growing without oxygen. Specialists revealed that some of these microorganisms were new, never found before. The discovery is of great value because it would allow the development of a new way to detect aggressive prostate cancer early.

Specialists believe that it is still too early to say for sure that the bacteria found are those that could cause cancer rather than just a useful biomarker.

Raúl Hernando Murillo, from the Javeriano Center for Oncology, highlighted in the latest issue of the Journal of Colombian Urology the importance of finding a way to detect the most serious prostate cancers. “Reducing mortality is the primary objective of screening (simple screening) for cancer and given the frequent late manifestation of symptoms, the search for the disease in an asymptomatic population is quite logical; however, this logic is based on the definition of neoplasia (tumors) malignant as the abnormal growth of cells capable of progressive invasion, ability which is determined by morphological changes and not by the dynamics of the disease. Today it is known that morphological changes have a broad spectrum with variable natural courses, including neoplasms that do not progress or that progress very slowly without manifesting during the patient's lifetime.”

Given this, he added that “the detection of indolent tumors is common to the search for the disease in its invasive state, since detection in pre-invasive states is exempt from this discussion.” The Colombian expert considered that “early detection of cancer cannot be done at any cost and that such intervention should avoid overdiagnosis of indolent tumors and therefore the undesirable effects of unnecessary treatment”.

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The team at the University of East Anglia, BBC reported, will continue to work to determine whether eliminating the infection caused by these bacteria could prevent malignant tumors. Until now, it has been known that a bacterial infection plays an important role in the development of some types of cancer such as stomach cancer, for example, and the use of antibiotics can reduce or eliminate the risk.

Prostate cancer is the second leading cause of death in cancer patients in Latin America. Specialists say that regular check-ups can detect early and increase the chances of treatment and cure, although they recognized that all men are at risk of prostate cancer, and that the most common risk factor is age. The older a man is, the more likely he is to suffer from prostate cancer.

The prostate is a gland in the male reproductive system that is located below the bladder and in front of the rectum. It contains cells that produce part of the seminal fluid that protects and nourishes sperm. Its size may change as a man ages. Cancer in this organ is caused by the malignization of certain prostate cells.

According to a publication by the Mexican Society of Urology, “it usually occurs after age 50 and its symptoms are no different from those of benign prostatic growth (BPH). Its timely detection allows it to be cured either through surgery or with some other type of procedure,” he said.

If a cure is not achieved, the scientific entity added, “it is also possible to carry out palliative treatments that allow to prolong the survival of these patients. The lack of adequate information and the 'macho' attitudes of patients are what prevent us from being able to cure the vast majority of patients who suffer from it, since they do not go to the urologist for their routine check-up after 40 years of life,” he warned.

After the diagnosis of prostate cancer, there are different treatments. “Applying general measures such as avoiding agents that cause inflammation to the organ, having adequate fluid intake and the use of specific medications or performing surgeries are the alternatives for treatment,” added the Mexican scientific society.

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Although prostate cancer is not always fatal, some tumors grow slowly and without causing problems for the patient and only need to be controlled. But science still has the challenge of diagnosing and applying rapid treatments to men who have the most aggressive versions of the disease, since some tumors are rapidly growing. The possibility of distinguishing through a urinalysis that there is a risk of suffering aggressive cancer will make it possible to develop unnecessary treatments for those who have not so aggressive tumors.

PSA blood tests and biopsy are currently available screening tests, although they cannot always predict which cancers will be harmful.

Research conducted by the University of East Anglia was conducted on 600 patients, one group suffering from cancer and the other not, in order to evaluate the usefulness of the bacterial urine test. Two of the five types of bacteria found were named after two sponsors of the study Porphyromonas bobii, by The Bob Champion Cancer Trust and Varibaculum prostatecancerukia, by Prostate Cancer UK.

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“Among the things we don't know yet is how people get these bacteria, whether they are causing cancer, or whether a poor immune response allows the bacteria to grow,” explained Dr. Rachel Hurst, a member of the research team.

The expert said that the team she is part of hopes that her findings and the work she will face in the future “may lead to new treatment options, which could delay or prevent the development of aggressive prostate cancer.” “Our work could also lay the groundwork for new tests that use bacteria to predict the most effective treatment for prostate cancer in every man,” he explained.

Meanwhile, Dr. Colin Cooper, one of the research directors, told the BBC that he was very sure that the findings were real: they had followed rigorous measures to ensure that there was no possibility of contamination while carrying out laboratory work. The expert assured that it is possible that some of the bacteria discovered are producers of hormones that drive the development of aggressive tumors.

“Nearly four out of 10 cancers in the UK are linked to known risk factors, such as smoking and obesity. But there are other risk factors that cause cancer, such as bacteria, that we know only beginning to identify,” said Dr. Sam Godfrey of Cancer Research UK.

“More studies are needed to establish how these bacteria are involved in the growth of prostate cancer, but this research could help generate new screening and prevention tools that would help reduce the impact of these cancers on society,” he added.

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According to the Pan American Health Organization (PAHO), around 413,000 new cases of prostate cancer are diagnosed each year in the Americas. In the same period, approximately 85,000 patients die and 1 in 7 men will be diagnosed with prostate cancer in their lifetime.

Dr. Carlos Silva, head of the Oncology Service of the Austral University Hospital and British Hospital of Buenos Aires, and coordinator of the psychosocial area of LALCEC, emphasized that “a timely study can save a man's life”. “Late detection can happen because in its early stages this type of cancer has no symptoms, so we emphasize the importance of routine studies,” the specialist added.

“It is advisable to consult with the urologist who will be able to advise the patient on the best way to monitor the health of his prostate. If diagnosed early, the chances of cure and survival are high,” said Dr. Gonzalo Vitagliano, head of the Oncology and Urolaparoscopy section of the German Hospital.

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Different prostate cancer patients may experience different symptoms, and some men do not experience any symptoms. The CDC warns that the most common signs may be difficulty urinating, weak or interrupted urine flow, difficulty emptying the bladder completely. People who have prostate cancer may also have to urinate more often at night, experience pain when urinating, and may even have blood in their urine or semen. Ejaculation can also become painful. The CDC says men with prostate cancer may also experience pain in the back, hips, or pelvis that doesn't go away.

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