Cracking the Code
APCR is joining an international team of leading scientists and clinicians to crack the prostate cancer code. The study will have unprecedented power to solve key issues for the management of men who have or who are at risk of developing prostate cancer.
At the heart of everything we do at Australian Prostate Cancer Research are the patients. At the APCR Prostate Cancer Centre we are in the unique position to be able to diagnose and treat patients informed by the most recent research outcomes.
We are now conducting groundbreaking research for the Pan Prostate Genetics Consortium. The ultimate goal is to decode the genetic makeup of prostate cancer by collecting, comparing and analysing data on an unprecedented global scale.
The Consortium is an international collective of renowned prostate cancer scientists and researchers working together to sequence the prostate cancer tumours searching for genetic variations. For the first time, data from prostate cancer patients globally will be collected and analysed, including data from different ethnicities, different cancer stages, and cancer patients managed by different treatment types.
Ultimately, this research will improve the outcomes of the disease in patients. We will be able to test and identify which tumours will turn into more dangerous cancers and need to be treated more aggressively from the outset, and optimise treatment for all patients based on their specific prostate cancer.
Our team will conduct their research at Melbourne Bioinformatics, which houses sophisticated computers that work at extraordinary speeds mapping DNA. It will be the largest collection of genetic data on prostate cancer ever assembled and will be able to address how the genetics of prostate cancer influences the outcomes of the disease in patients.
From Therapeutic Nihilism to a Cure – by Prof Tony Costello AM MD FRACS, Clinical Director, Prostate Cancer Centre
Before the advent of penicillin and vaccinations, prognosis for patients with bacterial and viral diseases was often catastrophic. Similar groundbreaking discoveries in the diagnosis and treatment of prostate cancer are bringing us ever closer to a cure.
Prior to 1980 prostate cancer patients faced horrific treatment options. The most common operation for prostate cancer was the removal of both testicles, and the most common medical treatment was administration of Oestrogen with its horrible feminising side effects for men.
Then came two great leaps forward in prostate cancer diagnosis and management: the development of the PSA test allowed a 9 year lead time from diagnosis to advanced disease, and Dr Patrick Walsh from Johns Hopkins pioneered a safe anatomical surgery for the operation of radical prostatectomy.
Prostatectomy in the 1980s required a 21 day hospital stay, was often accompanied by a 5 litre blood loss, 50% likelihood of incontinence and a 100% certainty of erectile dysfunction. With the miraculous appearance of the Da Vinci robot assisted surgery, the operation was transformed. Patients now face a day stay surgery with an almost zero need for blood transfusions, 95% continence after surgery and a 40-50% chance of recovering their potency.
After 2004, the development of taxane based chemotherapy showed a survival advantage beyond castration failure. We also now have hypothesised the concept of early metastatic disease (oligo or few metastases) where the metastases can be targeted with stereotactic radiation therapy or surgically removed avoiding the necessity for immediate hormone therapy.
Most recently we have seen the introduction of theranostics, the coupling of therapy and diagnostics. Radioactive emitters can be sent directly to prostate cancer metastases and give a lethal radiation dose to the prostate cancer cells with little or no collateral tissue damage.
Finally, the recent “moon shot for cancer initiative” in the United States may herald the arrival of a combination of immune therapeutics that has already shown to be successful in melanoma treatment. Our aim as treating doctors is to induce a state of prolonged cancer remission with occasional targeted therapeutic intervention.
We have come a long way in our ability to look after most prevalent cancer in Australian men.