Dr Judith O’Malley-Ford
Research and development in the 21st century is a rapidly changing landscape. Advances in technology have been the driving force to further advances in medical treatments. The drip and trickle effect of progress in newly found horizons of information has suddenly become a torrent of new information. All of which is good news for managing the medical problems facing an ageing population in the future.
General practitioners are at the forefront of primary healthcare in a collaborative role with other sectors of health providers and those with scientific expertise. Prostate cancer (PC) is one such disease where innovation is changing the way the disease is managed. Early diagnosis of the disease remains a significant problem. Despite newer, more sensitive magnetic resonance imaging technology detecting smaller and smaller sized lesions, there is still a finite size before these lesions are able to be located.
The prostate specific antigen (PSA) test is not specific enough for detecting or accurately diagnosing early PC with certainty as distinct from the benign enlargement of the prostate which occurs with increasing age. The PSA test was never intended as a screening tool.
Not infrequently, some cancers may present at a time when the disease is already advanced. PC is one of a number of cancers where this applies. Some families carry an inherited risk for certain cancer markers in their DNA which predispose them to these cancers, e.g. bowel cancer, breast cancer, and PC, more readily than in the general population.
“We are facing a cancer epidemic, and no matter what, it will affect businesses,” according to leading cancer specialist and Medical Director of Healthscreen UK, Prof Gordon Wishart who explains how companies and organisations can protect themselves, and save lives, by supporting cancer screening and supporting their staff. Cancer will affect their employees or the partners of their employees – and therefore workplaces of these people, business profitability, and productivity. We all therefore have a role to play.1
Prof Veronica James has used low angle fibre diffraction of skin samples to detect PC in blinded studies. The technique was able to detect the disease in its very early form long before it is possible to diagnose using other current methods.2 The test can determine whether the disease is aggressive or not and in addition can determine if the cancer has been cured. Such a discovery could provide an effective screening tool for PC.3 Such a discovery can improve the diagnostic power for a screening test for PC. As the population ages, the incidence of cancer is expected to become a more significant factor in the lives of ageing people everywhere. Early diagnosis has never been more imperative. With the discovery of effects on collagen in the presence of disease, less reliance and importance may be attributed in the future to the PSA test.
It is a great step forward for the world of medicine and the community when a whole new diagnostic method becomes available for early diagnosis and ongoing treatment monitoring in the management of cancer diseases.
Knowledge and far-sighted visions are the dreams that enabled man to walk on the moon, and more recently landed spacecrafts on Mars and another on a comet zooming through space, which will soon be visible from Earth. Scientific technology and knowledge are constantly expanding.
Creative thinking and original thought often challenge the status quo. Creative thinking needs support from like-minded people regardless of their scientific discipline. Embracing new technology produces important new principles in problem solving.
This is demonstrated in a number of ways:
- Importance of thinking outside the box in diagnostic medicine.
- Replacing an inefficient test like the PSA test with a more reliable screening test.
- Including new forms of technology into the medical diagnostic process.
- Embracing the concept of change from research and development.
- Highlighting features of new tests, enabling early and more accurate diagnosis.
- Scientists like Lister, Pasteur, Jenner, and Curie were vilified, only to be proven correct later in their assertions.
- Providing a vision for the future of diagnosing PC and other cancers.
- New models for cancer prevention, diagnosis, and treatment.
- Everyone has a role to play in combating cancers.
- Planning for the future with new models for cancer management, embracing the whole community.
1. Wishart G. How business can fight cancer. Business Matters. 2015. Available at: http://www.bmmagazine.co.uk/news/business-can-fight-cancer/.
2. James VJ. Extremely early diagnostic test for prostate cancer. J Cancer Ther. 2011;2(3):77.
3. James VJ, O’Malley Ford JM. Research article. Fibre diffraction analysis of skin offers a very early and extremely accurate diagnostic test for prostate cancer. J Cancer Res. 2014;2014:Article ID 179608.