Prostate cancer is the most commonly diagnosed form of cancer for men in North America. Prostate cancer deaths have been in decline since the mid-1990s after the discovery of Prostate-Specific Antigen (PSA), which, when used for screening, results in a steep increase in the number of early diagnoses. A large percent of these PSA-detected cases do not express clinically, are slow growing, and do not require treatment, and therefore do not contribute significantly to overall mortality. Conversely, some slow growing cancers are very aggressive and result in death.
Treatment for prostate cancer can have significant negative impact on quality of life and healthcare costs, and should only be utilized when the cancer itself is likely to be fatal. Treatment recommendations are based on PSA levels , clinical staging, and Gleason scoring. Active surveillance is a preferred approach when the disease is low-risk and small. Significantly, 5-10% of individuals with low-risk disease treated up-front experience poor outcomes. Additionally, >40% of active surveillance patients may progress and require treatment – and half of those will ultimately fail treatment. The effectiveness of active surveillance is limited without a clinical tool to accurately assess risk of progression.
In small pilot studies, Dr. MacAulay’s lab has demonstrated the ability to predict aggressive behaviour in prostate cancers with >80% accuracy using a specific imaging technology that uses the measurement of GOALS in individual cells along with the cell’s position within the patient’s tissue.