Radiogenomics in Prostate Cancer

What Is Prostate Cancer?

The human body contains cells that control the important metabolic reactions of the body. These cells grow rapidly and replace the damaged ones. In addition, certain genes are present in the body that command the brain and regulate cell growth. However, the problem arises when these cells become protective. As a result, the cells proliferate uncontrollably and form a mass or tumor. This tumor can be benign (non-cancerous) or malignant (cancerous). When this tumor turns cancerous, the damaged cells spread and infect the surrounding organs. When this cancer originates from the prostate gland, it is known as prostate cancer. Mostly, prostate cancers grow slowly and rarely spread to other organs. Sometimes, patients might not be aware of cancer and present with symptoms only when the cancer turns aggressive.

What Is Radiogenomics?

Radiomics and radiogenomics are the most promising fields of cancer research. The term radiogenomics can describe the study of genetic variations associated with radiation. It also denotes the relation between cancer imaging features and genetic variations. Patients suffering from prostate cancer are at the highest risk of developing radiation toxicity or genetic variations. Radiogenomics also helps to study the response of tumors to radiation therapy. Prostate cancer is one of the most common reasons for mortality in the United States because people undergo radiotherapy but are unaware of the effects of radiation. Radiogenomics helps to study the risks associated with prostate cancer to save the patient’s life.

What Are the Signs and Symptoms of Prostate Cancer?

Prostate cancer might not cause any symptoms in the initial stages, but the following symptoms are usually noticed when cancer damages the gland:

• Difficulty in passing urine.

• Difficulty in starting the urine stream.

• Hematuria (blood in the urine).

• Blood in the fluid produced by the prostate gland.

• Pain in the bones.

• Weight loss without exercise.

• Erectile dysfunction.

What Are the Risk Factors for Prostate Cancer?

Scientists are still working to figure out the exact cause of prostate cancer. Some doctors believe that prostate cancer occurs due to a change in deoxyribonucleic acid (DNA). It is because the DNA contains information and instructions regarding cellular activity. When the cell's DNA is defective, they continue to increase, and the healthy cells die. In some time, abnormal cells grow and spread to nearby organs (metastasis). The risk factors for prostate cancer are listed below:

1. The risk of prostate cancer increases with age; people above 50 are more likely to experience prostate cancer.

2. If the parent, brother, or other family member suffers from prostate cancer, the child is more likely to suffer.

3. Obesity or excess weight increases the risk of prostate cancer, so it is important to maintain a healthy weight throughout life.

Radiogenomics in Prostate Cancer: What Has Been Discovered So Far?

Radiogenomics and radiomics have opened new avenues for research in prostate cancer. They have been designed to improve the disease management of patients suffering from prostate cancer. Radiogenomics involves the conversion of images to mathematical figures and automated algorithms. This increases the clinical value of prostate cancer management. In the medical field, radiogenomics helps in the screening, classification, and detection of prostate cancer. The following tests have been discovered in radiogenomics:

• Prostate Cancer Antigen 3 (PCA 3) - PCA 3 is an expression analysis method used in patients suspected of prostate cancer. High levels of PCA 3 are usually indicative of prostate cancer. Sometimes, a biopsy might not be able to detect cancer, but PCA 3 is of great help.

• Decipher Test - Decipher test is done after radical prostatectomy (removal of the prostate gland) and prostate biopsy to detect the death rate. This test also helps to detect the chances of recurrence of prostate cancer.

• Oncotype Dx Test - The Oncotype Dx test involves cancer-causing genes and helps to detect the aggressiveness of prostate cancer. The patient is at risk of developing cancer if the cancer-producing genes are present in large amounts.

• Confirm MDx Test - It is a commonly used test to screen for genetic modifications in prostate cancer patients. Alterations in the DNA can be identified using this test.

• Prolaris Test - It is done to analyze the prostate tissues after biopsy. This test helps to indicate the risk of prostate cancer.

How to Manage Prostate Cancer?

The treatment of prostate cancer depends on how fast the cancer is growing and whether it has spread to the surrounding organs. Low-grade cancers might not require any treatment, but the following treatments must be done if cancer grows at a rapid rate:

1. Surgery - Surgery is done to remove the prostate gland (radical prostatectomy), surrounding tissues, and lymph nodes. The surgical procedures are described below:

• Robot-Assisted Prostatectomy - It is a procedure in which several small incisions are made in the abdomen. The surgical instruments are attached to the robot to carry out the procedure. The doctor sits at the console and guides the robot to remove the prostate gland and the affected tissues.
• Retropubic Surgery - During this procedure, a large incision is made in the abdomen to access and remove the gland. This procedure is not commonly performed.

2. Radiotherapy - Radiotherapy or radiation therapy uses high-energy radio waves to kill cancer cells. The radiotherapy methods are described below:

• External Beam Radiation - In this procedure, the patient is laid on the treatment table, and an X-ray machine is positioned over him. The machine moves around the patient and emits radiation that passes through the body and helps to kill cancer cells. The cancer cells are damaged to the extent that they cannot repair themselves and die. Radiation therapy is usually recommended when surgical treatments are ineffective.

3. Cryoablation - Cryotherapy or cryoablation is a procedure in which a very cold gas freezes the prostate tissues. The prostate tissues are thawed, and this cycle of freezing and thawing helps kill cancer cells.

4. Hormone Therapy - Hormone therapy includes those drugs that inhibit testosterone secretion. Because prostate cells depend on testosterone for their growth, hormone therapy aims to administer those medications that prohibit testosterone secretion.

5. Chemotherapy - Chemotherapy is a procedure in which powerful drugs are administered to the patient because these drugs are lethal for cancer cells. The side effects of chemotherapy drugs include nausea, hair fall, tiredness, vomiting, and increased risk of infections.

6. Immunotherapy - As the name suggests, immunotherapy uses the body’s own immune system to fight cancer cells. The proteins present in the body or made in the laboratory are used to boost the body's immune system and help to fight cancer.

Conclusion:

Prostate cancer is commonly seen in elderly men after 50 years of age due to several reasons. Radiogenomics helps to research the effects of prostate cancer on genes. It also helps the doctor know about the side effects of the treatment procedures so that the patient’s life can be saved. The other aspects of radiogenomics are still under research. Earlier, only magnetic resonance imaging (MRI) was considered the best method to evaluate prostate cancer. However, radiogenomics has changed the scenario and provided various methods to deal with cancer. People often become depressed when diagnosed with cancer, which is wrong. Medical science has advanced a lot, and radiogenomics has provided new research opportunities for prostate cancer treatment. So, the patient need not worry and must consult the doctor as soon as the signs and symptoms of prostate cancer are noted to prevent complications.