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Take the prostate out of the fire - as early as possible

A new approach to the detection of prostate cancer. It turns out that the measurement of zinc and its mapping in the prostate may indicate both the exact location of the tumor and its degree of violence

Right: Dr. Sena Shilstein, Prof. Amos Barskin, Dr. Rachel Chetzik and Marco Cortezi. Photo: Weizmann Institute
Right: Dr. Sena Shilstein, Prof. Amos Barskin, Dr. Rachel Chetzik and Marco Cortezi. Photo: Weizmann Institute

Military, or business intelligence, usually allows us to prepare for what is to come effectively, curb unwanted processes, and support positive trends. Early detection of diseases, including cancer, allows modern medicine an interval of time for treatment, which significantly increases recovery rates. Therefore, developing advanced methods for the early detection of cancer is a goal aimed at by many scientists in different parts of the world.

The currently accepted method of prostate cancer screening, for example, is based on a combination of manual examination, ultrasound examination, and examination of the level of a certain protein produced in the prostate (PSA) in the blood. High levels of the protein may indicate an increase in the prostate, but also the presence of benign tumors. The sensitivity and reliability of each of the tests and of all three in combination is insufficient: in many cases they do not detect an existing tumor, and in a significant number of cases there is a "false alarm". If that is not enough, these tests also do not provide any information regarding the size or the exact location of the tumor, and even more importantly, they do not provide information about the degree of violence of the tumor or its clinical stage. Therefore, today a great many men over the age of 60 are referred for a needle biopsy examination, which not once (in fact, in three out of four cases), results in a negative result, that is, there is no proof of the existence of a cancerous tumor (either because it does not exist, or because the test, performed by the method " blind", did not hurt him). Since it is an expensive, painful test, with risks of complications, many scientists, in different parts of the world, are trying to find a non-invasive replacement for it. This state of affairs, combined with the fact that prostate cancer, which is very common among men over the age of 60, is the second deadliest cancer among men, and as a result of which approximately 250,000 people die worldwide each year, indicates the need to develop new screening methods, which will enable early detection , reliable and sensitive of the disease, as well as identifying the exact location of the tumor, its size, the stage of development in which it is located, and its degree of violence.

Prof. Amos Barskin and Dr. Rachel Chechik, together with Dr. Sena Shilstein and research student Marco Cortezi from the Department of Particle Physics and Astrophysics at the Weizmann Institute of Science, and in collaboration with Dr. David Waretzky from the nuclear research facility in Nahal Shurk, recently developed an approach New to the discovery of prostate cancer. This method was tested in clinical trials in collaboration with doctors Prof. Yaakov Ramon, Dr. Edward Friedman, Dr. Gil Raviv, Dr. Alexander Volkov and Dr. Nir Kleinman from the Sheba Medical Center in Tel Hashomer, and Dr. Avitar Muriel , Dr. Monica Hosser, Dr. Gabriel Kogan and Dr. Valerie Gladish from the Kaplan Medical Center in Rehovot.

The new approach developed from studies that are about 30 years old, which showed that the concentration of zinc - a chemical element found naturally in abundance in the prostate gland - is lower in prostate cancer patients whose tumor is in an advanced stage. In the last decade, insights were gained about the role that zinc plays in the prostate - it became clear that this substance, among other things, plays an important role in maintaining the chemical composition of the prostatic fluid secreted by the epithelial cells of the gland.

In the first phase, the team of scientists wanted to check whether it is possible to detect reduced levels of zinc in the prostate even in the earliest stages of the tumor. If this is indeed the case, it is possible that detecting low levels of zinc could be used as a marker for the early detection of prostate cancer. The researchers examined samples taken from approximately 600 patients who underwent a biopsy. The concentrations of zinc in the prostate samples were measured using a device for testing chemical elements based on X-rays, and were compared to the histological findings (biopsy findings). The research report, published in the scientific journal The Prostate, shows that low levels of zinc in prostate tumors can be detected at a very early stage of the disease. The researchers also discovered that there is a correlation between the decrease in zinc levels and the degree of violence of the tumor: the more violent the tumor, the more significant the decrease in zinc levels. In addition, it was found that the healthy tissue surrounding the tumor contained normal and normal levels of zinc.

These three findings show that the measurement of zinc in the prostate and its mapping may indicate both the exact location of the tumor and its degree of violence.

In a subsequent study, the findings of which were published in the scientific journal Physics in Medicine and Biology, the scientists tested whether imaging of zinc concentrations in the prostate using X-rays ("X-rays") could serve as a basis for a non-invasive diagnosis. To evaluate the effectiveness of the method, the researchers examined computer simulations, based on zinc values ​​obtained in the clinical trials. The imaging analysis not only revealed the areas where there was a reduction in zinc levels, but also provided information on the extent and scope of the reduction. In this way, the scientists were able to diagnose whether the tissues in certain areas are cancerous or healthy, and also determine the degree of violence of the tumor, its size, and its exact location in the prostate gland.

Based on these findings, the scientists began a research and development program to advance the development of a non-invasive tracker, which would map the zinc levels in the prostate gland using X-ray ("X-ray") radiation. The scientists believe that the new method they developed will make it possible to identify even small, clinically significant tumors. The scientists hope that the tracker's performance, that is, its ability to detect and identify tumors, will be better as the tumors are more aggressive.

Dr. Chechik: "We believe that a detection system based on our research will also - by providing information on the violence, size and location of the tumor - indicate the possibility that it has spread to other areas, outside of the prostate gland. The findings of such a system will also help in making the decision whether and how to perform tissue samples (biopsy), while preventing such tests from being performed unnecessarily. The information about the location of the tumor may significantly increase the sensitivity of the biopsy test by directing the needles to the suspicious area." Prof. Barskin: "The method may help in the future in making clinical decisions, and also be used to direct therapeutic tools in the disease. After the treatment, the system can also be used for non-invasive monitoring of the effectiveness of the selected treatment."

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