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Prostate cancer develops in a man’s prostate, the gland just below the bladder that produces some of the fluid in semen.  It’s the most common cancer in men after skin cancer.  Prostate cancer often grows very slowly and may not cause significant harm; Although some types are more aggressive and can spread quickly without treatment.

Researchers from Weill Cornell Medical College have shown that the presence of a particular protein in biopsied prostate tissue substantially increases the likelihood that cancer will develop in that organ.  The discovery will may help physicians decide how closely to monitor men potentially at risk for the cancer.

Their findings, reported in the Journal of Clinical Oncology, are the first to quantify, in the setting of a clinical trial, the increased risk of prostate cancer development from the protein ERG.

Researchers at Weill Cornell Medical College are looking at specific changes within prostate cells, from an initial biopsy, to determine which men have a higher risk of prostate cancer development and need repeat biopsies or other types of monitoring. This study starts to fill in the picture for about 10% of prostate biopsies.

Investigators found that 53% of men whose prostate biopsies showed expression of ERG protein developed invasive prostate cancer, compared to 35% of men whose biopsies were ERG-negative.  All of the biopsies were classified as having high-grade prostatic intraepithelial neoplasia (HGPIN), which are lesions that may or may not turn into cancer.

The findings mean that potentially thousands of men a year– those with ERG-positive HGPIN biopsies, may benefit from increased surveillance and early treatment of prostate cancer, while those whose HGPIN biopsies come back ERG-negative may be able to avoid unnecessary future biopsies, according to current findings.

This research is the largest ever conducted that focuses on looking at HGPIN and ERG in a systematic way.  It’s findings have established that more than half of patients with these biomarkers go on to develop prostate cancer.  When confirmed in larger studies, testing for ERG in these precancerous lesions may change clinical practice in how men are evaluated with abnormal biopsies and may lead to earlier cancer detection.


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