Mathematics and Biology Unite to Save Lives and Reduce Health Care Costs

It's an unexpected combination, but it is one that could benefit countless cancer patients worldwide.

A collaboration between an NRC-IIT researcher and doctors at the Atlantic Cancer Research Institute in Moncton, New Brunswick, is blending mathematics and biology in the hopes of improving the diagnosis and treatment of prostate cancer and other genetic diseases.

Applying math to medicine

NRC-IIT researcher Dr. Nabil Belacel has always been fascinated by the medical field, but his chosen field of study was mathematics. While working on his PhD in Brussels, Belacel tried to apply his mathematical and computer science skills in a clinical setting to help doctors diagnose disease. Using algorithms to sort through medical data, he was the first person to apply classification methods based on multiple criteria decision analysis fields to medical diagnosis.

Now, through a collaboration with Drs. Rodney Ouellette and Miroslava Cuperlovic-Culf of the Atlantic Cancer Research Institute, Belacel is applying what he learned during his studies to help NRC improve cancer diagnosis, particularly for prostate cancer.

Improving cancer diagnosis

Prostate cancer is the most common cancer among Canadian men, affecting one in seven of them. It is estimated that in 2006, 20,700 Canadian men will be diagnosed with prostate cancer and 4,200 will die from the disease.¹

Prostate cancer screening is currently based on the digital rectal exam and the Prostate Specific Antigen (PSA) test. The accuracy and effectiveness of the PSA test has recently become subject to increasing criticism, partly because PSA levels in a blood sample can be affected by factors like age and other diseases. What's more, critics claim, the test produces numerous 'false positive' results which in turn give rise to unnecessary, costly, and often painful procedures aimed at making accurate diagnoses.

Belacel and his partners from ACRI hope to change all that. Their new method uses gene expression data from DNA microarrays to identify the genetic markers of prostate cancer in biopsy samples. The process produces a great deal of data that would normally be difficult to analyze, however, Belacel's mathematical algorithms make it possible to sort through all the information. The team has identified a panel of eight genes that can be used to diagnose prostate cancer. Once genetic markers are found, they can help predict cancer and become targets for treatments and drug therapy.

The result is a new and more cost-effective way to identify prostate cancer tumours with 98% accuracy – a huge improvement over traditional methods. Better accuracy also means fewer tests are required to make a diagnosis, lessening patient discomfort and further reducing health care expenses. The ability to diagnose cancer earlier and more effectively could ultimately save many lives.

Congratulations to Dr. Belacel, two of his NRC-IIT colleagues (Georges Corriveau and David McGuire), an NRC-CISTI employee (Patricia Oakley), and both ACRI collaborators for recently winning second place in the Technologies Available for Licensing category of NRC's 2006 Business Case Challenge.

"Better knowledge equals earlier diagnosis," explained Belacel, "Knowledge is the enemy of disease." Belacel said that it is increasingly difficult for doctors to make sense of all the information they are inundated with from different sources.

"The classical approach is, 'Okay, he has these symptoms, so he has this disease, so give him this treatment.' But now it's not [as] easy as that," said Belacel. Diseases are increasingly complex and difficult to treat. Doctors might encounter any number of tumours, each with its own specific treatment requirements. It is no longer simple to decide what a disease a patient is suffering from and then pinpoint a specific treatment based on a few symptoms.

But new research, like that of Belacel and his research partners, aims to make it easier for doctors to tackle these problems, improving treatment overall. This project has also contributed to the development of the Cancer Populomix Institute, in which NRC-IIT is a founding partner, and which will be headquartered at the National Research Council in Fredericton. The Cancer Populomix Institute will work to identify biomarkers, the indicators that someone may have cancer. The hope is that in isolating these markers, cancer can be detected sooner, when patients have the best shot at beating the disease.

So far, the team has had great success with prostate cancer analysis, and Belacel said they plan to keep moving forward. In the future, they hope to use the same methods to detect colon and breast cancer as well as other, non-cancerous diseases. They are also exploring the possibility of taking samples from urine or blood tests, rather than material from biopsies, in order to make the diagnostic process even less invasive.

A team effort

Belacel stressed the importance of collaboration in this project. The application of both mathematics and biology to solve diagnosis problems required close cooperation between Belacel at NRC-IIT and Ouellette and Cuperlovic-Culf at the Atlantic Cancer Research Institute: Belacel used his algorithms to locate particular genes before sending the information to the Atlantic Cancer Research Institute where his research partners would conduct further research and validate the findings.

But the process was about much more than simply sending emails back and forth, Belacel said. The collaborators were in constant discussion.

"I have to understand the biology side of what I am doing, not just stay alone in my office and send results without knowing what's happening and what is the importance of the work I'm doing," Belacel said.

Good communication is vital, but can be difficult in a collaborative project like this, he explained. Everyone involved has to learn to speak each other's language. Belacel found himself teaching his research partners at the Atlantic Cancer Research Institute about the mathematical aspects of the project, while at the same time learning from them about the biological side.

Belacel also credits NRC-IIT for creating a good environment for researchers to work in – one that allows them the freedom and trust they need to really focus on a project, and provides the resources they need to carry out their research and get results.

The collaborative experience has been a good one for Belacel, he said, and he hopes to continue working with the Atlantic Cancer Research Institute. The success of this project shows the potential for similar collaborations in the future between NRC-IIT and other biodiagnostic or biotechnology institutes, and especially with the work being carried out at the Cancer Populomix Institute.

For the time being, Belacel and his partners at the Atlantic Cancer Research Institute continue work together to develop their project in the hopes of applying their expertise to other diseases and making it less invasive. Their work promises to improve the lives of countless Canadians suffering from cancer.

Mathematics and Biology Unite to Save Lives and Reduce Health Care Costs

Applying math to medicine

Improving cancer diagnosis

A team effort

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