Prostate Cancer, Prostate Hyperplasia
Conditions
Brief summary
This is a prospective, single center translational multiple cohort study to investigate the association of gut microbiota and prostate cancer.
Detailed description
Prostate cancer (PCa) is a significant health care system challenge. PCa is the most common male cancer in Finland and most western countries. Interestingly, although the incidence of indolent (latent) PCa is very similar throughout the globe, there is a remarkable global age-adjusted incidence variation (up to 40-fold difference between highest and lowest incidences). Epidemiological data suggest that aging in men is associated with neoplastic processes in the prostate but only a subset of men will develop a true malignancy potentially affecting their life-span or quality of life. Genetic factors have a significant effect on PCa risk, but very likely life-style (e.g. diet and physical activity) affect PCa risk as well, but the mechanisms mediating protective or harmful effects of life-style remain unclear. Gut microbiota, i.e. the collection of microbes colonizing the gastrointestinal tract, has been acknowledged to play significant role in many metabolic pathways and pathogenetic processes in the human body. Although there is some evidence suggesting that gut microbiota affects therapy responses (especially androgen deprivation) in PCa, it´s potential role in prostate carcinogenesis is not well documented. Our previous studies suggest that gut microbiota composition is different in men with and without PCa potentially contributing to the Pca risk, and that changes in steroid hormone synthesis may be one mechanism how gut microbiota affects PCa risk. PROMIC is a prospective, single center translational multiple cohort study to investigate the association of gut microbiota and PCa. The main aim is to validate our preliminary findings of association between gut microbiota and PCa. We also study metabolic characteristics in the gut, systemic circulation, and prostate tissue in men with different gut microbiota signatures. The study is carried out in Turku University Hospital and University of Turku.
Interventions
OTHERMRI scan and laboratory visit
Prostate MRI scan is performed according to the protocol used in earlier studies (PMID 31158230). In addition to the PCa diagnostics, the scan will include abdominal imaging to body composition analysis (visceral and subcutaneous fat and psoas muscle). Baseline blood and urine samples are collected in Turku University Hospital laboratory.
PROCEDUREProstate biopsies
The visit follows routine outpatient clinic protocol. The results from MRI and laboratory findings are discussed and the potential benefits and harms from prostate biopsies are evaluated. After a mutual decision, prostate biopsies are performed.
PROCEDURERadical prostatectomy and blood, urine and tissue sampling
Baseline blood and urine samples are collected at the time of surgery. Robotic assisted laparoscopic prostatectomy (RALP) is performed according to routine protocol. Routine diagnostic histopathological procedures will be followed, and study tissue samples are obtained in the department of pathology.
PROCEDURETURP and blood, urine and tissue sampling
Baseline blood and urine samples are collected the time of surgery. TURP is performed according to normal protocol. Routine diagnostic histopathological procedures will be followed in the department of pathology. Additionally, tissue samples (a total of 10 resection chips) will be collected for study analyses. Due to the study, no additional tissue samples are removed, i.e. study samples are from the tissues removed as clinically indicated.
PROCEDURERadical cystoprostatectomy and blood, urine and tissue sampling
Baseline blood and urine samples are collected at the time of surgery. Radical cystoprostatectomy is performed according to routine protocol. Routine diagnostic histopathological procedures will be followed, and study tissue samples are obtained in the department of pathology.
Sponsors
University of Turku
Turku University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Provision of signed and dated informed consent form. * Ability and stated willingness to comply with all study procedures and availability for the duration of the study.
Exclusion criteria
* inability to comply with study procedures or unwillingness to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gut microbiota signature | immediately before prostate biopsy | Gut microbiota signature in men with clinically significant prostate cancer, clinically non-significant prostate cancer, and benign prostate histology |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gut metabolomics | immediately before prostate biopsy | Metabolic characteristics in the gut in men with different gut microbiota signatures |
Other
| Measure | Time frame | Description |
|---|---|---|
| Systemic circulation metabolomics | immediately before prostate biopsy | Metabolic characteristics in the systemic circulation in men with different gut microbiota signatures |
| Prostate tissue metabolomics | immediately before prostate biopsy | Metabolic characteristics in the prostate tissue in men with different gut microbiota signatures |
Countries
Finland
Contacts
Primary ContactPeter J. Bostrom, MD, PhD
Backup ContactTarja Lamminen, PhD
Outcome results
None listed