Impact case: Prostate cancer treatment

Every year more than 10 000 men in Sweden are diagnosed with prostate cancer - the most common form of cancer among men. To find these patients at an early stage and to know how to separate the aggressive tumours from the more benign cases is key to successful treatment. It relieves suffering and saves both lives and resources.

Thousands of men in the ages over 50-55 take a PSA-test, where a blood sample is analysed for a certain protein that indicates a possible tumour in the prostate gland.  

But the test is far from fool proof. It misses between 30 and 50 percent of all aggressive cases of cancer. It also cannot distinguish between aggressive and benign cases. As a result, many patients undergo unnecessary follow-up procedures with a biopsy of the prostate to make sure. This is not only unpleasant but can also cause serious side effects like infections. 

Henrik Grönberg, professor of Cancer Epidemiology at Karolinska Institutet. Photo: Stefan Zimmerman.

Henrik Grönberg has worked on a refined test method, with better precision, for more than a decade. The result is Stockholm3, a blood test that combines several markers that provide a clear risk profile when added up. 

The component markers are a number of proteins, genetic data, plus clinical information about the patient. And these three aspects combined will indicate the risk of serious cancer for the individual. 

"It took a few years to work out which proteins and which genes to look for, and then we needed to create the complex algorithm that evaluates the compounded risk," says Henrik Grönberg,

With the method designed and fully worked out, Grönberg’s team tested it on 58 000 men in a clinical study between 2012 and 2015, and the results were clear.   

"Compared to traditional PSA-test we got more reliable results, better predictions, and we could avoid false positives. The test results were also easier to interpret," says Henrik Grönberg. 

Stockholm3 is now provided by an external company that was established in 2017.  

Henrik Grönberg estimates that it saves up to thirty percent of the total cost for the cancer treatments by early discovery of tumours and avoiding unnecessary biopsies. That amounts to more than fifty million SEK per year.   

Stockholm3 has not replaced the PSA-test, but is in use today locally in Sweden and Norway, Switzerland and Germany. And the method is on its way to be the recommended test method in the US guidelines. 

So even with clear and successful results it can take some time to see the clinical impact for new practices. "It is a slow process to establish a new method like this one, so you have to be patient and persistent. It takes longer than most people imagine," says Henrik Grönberg.

Henrik Grönberg's advice to those who want to commercialise their research

  1. You need good science and sound data to back you up. You can’t start a company on unclear results.
  2. You need to solve an issue worth solving, a real problem.
  3. Make sure you get help from competent people, who know how to start a business. That is a must.