Science thomsonreuters.com

The focus of my career has been on two of the most common cancers in the western world — prostate cancer in men and breast cancer in women and the remarkable similarities that exist for potential treatment techniques.

Simply, the severity of the diseases can be broken down into two progression rates: aggressive, that requires intensive and immediate treatment and then very slow that requires little or no treatment.

Although it is possible to detect the two progression rates in breast cancer, the task is much harder in prostate cancer and my focus has been on personalizing the diagnosis in each case.

The current theory follows that for the good of 49 men, one man has to give up his chance of being cured. It's easy to see the benefits if you are one of the possible 49 but very hard to accept if you are the one in 50 who now will die of the disease which the screening process would have saved.

The idea of preserving the quality of life in 49 patients at the expense one who will discover the disease later in life is ethically challenging. It is one of the most difficult research projects I have ever undertaken.

However, to me it seems like an obvious decision when you have 49 men not risking the complications of treatment which include impotence, incontinence and infection.

If we look at breast cancer, we now have tests in the US and Europe that re-assure the woman the disease is likely to have been cured by surgical removal.

The patient is reassured it would be unwise and overly expensive if she underwent treatment with cancer drugs that can cause her hair to fall out, her stomach lining to slump and to lose weight. All that can be avoided because a genetic test says her cancer has a very low chance of relapsing.

For prostate cancer, we still haven't got enough clarity and we need to work hard to catch up with the advances made in breast cancer detection and treatment. Our aim is to also prevent men from going forward into expensive and possibly life altering treatment for a disease they were probably better off never having had diagnosed in the first place.

The Thomson Reuters Integrity database I use for pharmaceutical products was originally focused on the drugs and the compounds themselves; their chemistry, their metabolism and the results of the clinical trials have done for them but for all types of disease, not just cancer. This has recently been augmented by BIOMARKERcenter, a new biomarker database that is a companion to the drug database itself.