Terry Kirkland was 64 years old when he was diagnosed with prostate cancer.
“We had a patient with the exact same cancer as you, Terry,” the diagnosing doctor told him. “He was 47, and, with aggressive treatment, we got him to 52.”
Kirkland couldn’t believe what he was hearing. Just weeks prior, during a routine prostate exam, his GP had assured him he had a “nice, firm prostate.” Having previously been diagnosed with higher-than-normal Prostate Specific Antigens (PSA), Kirkland interpreted his doctor’s comments as a sign he was in the clear. Now, he was being told he might have only a few years left to live.
“I said, ‘How about that? I think you just put an expiry date on me,’” he recalls.
Kirkland’s cancer was severe, scoring nine out of 10 on the Gleason scoring system, which assesses the severity of cancer within the prostate. His PSA count had risen from seven in 2007 to 30 at the time of his 2012 diagnosis. A count of five is often sufficient to prompt immediate referral to a urologist for cancer screening.
In the weeks and months following his diagnosis, Kirkland’s life changed drastically. He underwent a radical open prostatectomy, during which his prostate was removed via an incision extending from his penis to his navel. This was followed by external beam radiation therapy and a three-year course of hormone therapy treatments aimed at eliminating testosterone — the hormone most closely linked to prostate cancer growth — from his body.
Those treatments, however debilitating, alongside the fact his cancer was detected early enough, saved Kirkland’s life.
Kirkland’s story is not unique. Prostate cancer is one of the most common cancers in Canadian men, with roughly one in every eight men developing it during their lifetimes and one in every 30 dying from it, according to the Canadian Cancer Society.
“The key is early detection,” says Nawaid Usmani, an oncologist and professor at the University of Alberta. “If we detect prostate cancer early, we have excellent success rates. Where issues arise is when individuals are not screened or tested, or when the cancer is diagnosed at a late stage.”
While diagnoses have increased, mortality associated with prostate cancer has decreased since the 1990s, but methods for identifying prostate cancer have largely remained unchanged in recent decades. The most common methods — PSA tests, digital rectal exams (DRE), and prostate biopsies — are still prone to risks and inaccuracies. However, this is changing, thanks in part to Edmonton-based Nanostics.
Over the past decade, Nanostics has worked on developing a more precise method of detecting prostate cancer, one that might spare patients the hazards associated with other screening processes.
“Almost everyone with prostate cancer exhibits a high PSA level in their blood, but not everyone with elevated PSA levels has prostate cancer,” says Colin Coros, the chief commercialization officer at Nanostics. “The current test often has a lot of false positives, which sometimes results in a biopsy, which is not a nice test.”
“Not a nice test” undersells it. A prostate biopsy involves inserting around 12 to 13 needles into the prostate through the rectum to obtain samples for cancer detection. It’s a painful procedure carrying a small-but-not-insignificant risk of infection, which has resulted in fatalities among patients in the past.
Nanostics’ test — dubbed ClarityDX Prostate — utilizes a combination of machine learning artificial intelligence, blood biomarkers and clinical data from a patient’s Alberta Health history to create a more accurate test capable of predicting aggressive cancer.
“Our test isn’t designed to replace the PSA test, but if you have an elevated level then you would get our test,” says Coros. “We’re three times more accurate than PSA testing, so it’s a step before undergoing more invasive procedures like a biopsy.”
ClarityDX Prostate is already in use by health-care practitioners in Alberta, with plans to expand into other parts of Canada, the United States and Latin America. However, it was Alberta’s wealth of available data sets that enabled the technology’s development.
“With machine learning it’s about the quantity and quality of data,” Coros says. “Being in Alberta, with centralized health data, we had access to all of men’s health information. It’s the data and the quality of that data that made this happen.”
Recognizing the importance of that access to data, Nanostics is collaborating with Alberta Health Services to expand its access to, and use of, medical data, aiming to extend ClarityDX Prostate technology to other illnesses.
“We’re developing tests in bladder cancer, Alzheimer’s disease, cardiovascular disease,” Coros says. “It really opens up a lot of other avenues.”
This article appears in the May 2024 issue of Edify
