Prostate cancer devastates lives, claiming 11,000 men annually in the UK alone. Yet, for many, invasive treatments are unnecessary, leading to debilitating side effects like incontinence and impotence. Addressing this critical challenge, University of East Anglia’s prostate cancer research team is making strides toward life-saving diagnostics.
This is the first of a two-part series exploring their groundbreaking work. Dr Rachel Hurst, Senior Research Associate at Norwich Medical School, discusses two revolutionary diagnostic tests - the PUR test and the bacteria test - that aim to detect aggressive prostate cancer early and distinguish between life-threatening and harmless cases. These innovations have the potential to transform how prostate cancer is diagnosed and treated.
Crucially, philanthropic support plays a vital role in turning these breakthroughs into reality. In this interview, Rachel shares her journey, the meticulous science behind the tests, and the critical role donor contributions play in advancing this research to save lives.
Don’t miss part two of the series, where Professor Dan Brewer and Dr Sergio Llaneza-Lago explain the Tiger Test and how it’s shaping prostate cancer diagnosis.
How long have you been working in the prostate cancer team?
I joined in 2012, so…12 years. Wow. But it goes so fast!
Has a lot changed during that time?
Yes, when I started the research was newly developing, but now it’s getting much closer to patient benefit, which is very exciting. We are working on the development of tests to detect aggressive prostate cancer early.
At first we tested different biomarkers – the biological signs the tests pick up on – to see if they indicated aggressive cancer. We checked these very carefully – when some of the biomarkers seemed to be working Colin always said, “check that five more times!” It’s taken many years with both the PUR test and the bacteria test to find the best biomarkers, and the methods to identify them in a sample.
But now we’ve developed the PUR test and we know it's working well. To prove that we needed to screen more than 500 samples with various technologies, and that also takes a few years. It's amazing, thinking about how we started and how far we have come!
What does analysing samples for the tests look like day-to day.
Both the PUR and the bacteria test use urine samples. First, we use a centrifuge to split the urine into different parts – cells for the bacteria test, and the liquid part of urine for the PUR test. Then you add the probes for each test to a sample, and leave it incubating overnight, so the probes have time to bind to the biomarkers we’re looking for. The next day, you put the sample into the Nanostring machine. This machine is able to run both tests. The machine can detect which probes have bound to which biomarkers, showing which biomarkers are there, and how much of each is there.
How many samples can the machine process at a time?
The machine we have can process 12 samples in one run, which takes 24 hours from start to finish to generate the results. Until recently, that was all we needed – and there’s no way we could have got as far as we have without the current machine. But the project is now at a bigger scale than it’s ever been before, and now to test the thousands of samples we need to accredit and run the PUR Test, and the bacteria test. we need an upgraded molecular analysis machine. An upgraded machine would allow us to run many more samples at a time: we could go from being able to run 12 tests in 24 hours to a maximum of almost 200.
A new machine would mean we can run PUR quicker and more reliably, which would shorten the time to generate test results. And it would also speed up work on the bacteria test.
What does analysing the results of the tests look like?
For the bacteria test this is relatively simple – the results tell us which cancer-linked bacteria are present in a sample, and in what quantity. For PUR, it’s a bit more complex. We use the results to make a profile of how different genes are expressed in a sample. We have developed tools to identify which gene profiles are low, intermediate and high risk – so based on that we can predict the risk of aggressive cancer.
What will the PUR Test mean to patients when it becomes available?
The PUR test can show you if you've got aggressive prostate cancer up to five years earlier than current tests. So a patient could start on a new treatment plan earlier.
And it's a urine test as well, so it's non-invasive. The test can be done at home and then sent to the lab. So, once it's accredited, I think it'll be a really, really good test! To be able to deliver a test that can help benefit patients will be a dream come true.
"The PUR test can show you if you've got aggressive prostate cancer up to five years earlier than current tests. So, a patient could start on a new treatment plan earlier. And it’s a urine test as well, so it’s non-invasive. Once it's accredited, I think it’ll be a really, really good test!"
What are your hopes for the bacteria test?
The bacteria test will be super important in many ways. It will pick up whether people have the bacteria linked with prostate cancer. It will allow us to collaborate with other scientists around the world working on prostate cancer to study these bacteria too.
We also need this test to conduct a clinical trial investigating treatment options to target the bacteria linked to aggressive prostate cancer. With the test we could screen patients for bacteria linked to prostate cancer, give treatment if they are present, and see how that impacts on patients’ cancer over time. If that’s successful, patients could get treated early to get rid of the bacterial infection we've shown is linked to cancer, which could make a huge difference.
As we head closer towards getting the tests to the public - do you think donor contributions are going to help us get closer to that goal?
Absolutely. Donations make the work we are doing possible. They help speed up the process of getting these tests accredited and bringing them to patients. For example, if we could fund a new molecular analysis machine, that would mean work that now takes a whole month could be done in less than a week, bringing us closer to accreditation and generating the test results in a shorter time.
"Donations make the work we are doing possible. They help speed up the process of getting these tests accredited and bringing them to patients. With the help of donors, the research can make progress – we can make these discoveries and develop them for patient benefit."
I’d like to give a heartfelt thank you because with the help of donors the research can make progress - we can make these discoveries and develop them for patient benefit. Thank you so very much.
Learn more about our groundbreaking research and how it’s making a difference.
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