Researchers in Norway have uncovered new features that may help doctors tell the difference between slow-growing prostate cancer and the more dangerous aggressive type.
The discovery could eventually lead to simple tests using blood or semen to identify men at higher risk, making screening easier and more accurate.
Prostate cancer is the most common cancer among men in Western countries and becomes more common with age.
Many cases grow so slowly that they never cause serious problems, allowing men to live long lives without treatment.
However, some forms are aggressive and can return even after surgery. Doctors have struggled to predict which patients will develop these dangerous forms, making it difficult to choose the best treatment.
A research team from the Norwegian University of Science and Technology, led by Professor May-Britt Tessem, analyzed prostate tissue from patients using advanced techniques that examine genes, metabolism, and tissue structure at the same time.
Their findings were published in the journal Nature Communications.
By comparing samples from men whose cancer returned with those who remained cancer-free, the team identified patterns that appear to signal aggressive disease.
One major discovery was that aggressive prostate cancer has its own unique genetic activity. Tumors in high-risk patients showed a distinct pattern of gene expression that may help doctors identify which cancers are likely to spread or come back.
This information could allow some patients to receive closer monitoring or earlier treatment, while others with mild disease could avoid unnecessary procedures.
The researchers also found surprising changes in the tissue surrounding the tumor. Even areas that looked healthy showed signs of inflammation and altered metabolism. These nearby glands contained signals that attract immune cells and had reduced levels of important substances needed for normal function.
The findings suggest that aggressive cancer may affect the surrounding environment long before symptoms appear.
This insight is important because prostate cancer often progresses slowly. It can take many years—sometimes nearly a decade—before aggressive cancer returns after surgery. In the study, about 30 percent of patients experienced recurrence.
By studying samples collected 10 to 15 years ago, researchers were able to track which patients eventually developed aggressive disease.
Currently, prostate cancer screening relies on a blood test called PSA, physical examination, and imaging such as MRI scans. While these methods help detect cancer, they do not always show how serious it will become.
Better markers could help doctors decide who needs intensive treatment and who can safely avoid it.
Researchers also hope improved testing could encourage more men to get screened, as some hesitate to undergo traditional examinations. At the same time, identifying low-risk cases could reduce overtreatment, which can cause side effects such as incontinence, sexual problems, and reduced quality of life.
Although the work is still at an early research stage and not yet ready for clinical use, scientists say it provides an important step toward more personalized care. By understanding the biological differences behind aggressive prostate cancer, future screening methods could become simpler, less invasive, and more precise.
The discovery highlights how basic research can lead to major medical advances. In the long run, these findings may help doctors detect dangerous prostate cancer earlier while sparing many men from unnecessary treatment.
