Thomas Neville's Dynamic Analysis of Multiple PSA Results Leads to Better Reliability, Insights

Andrew Smith
Published: Saturday, Mar 28, 2015
Dr. Thomas Neville

Thomas Neville, PhD

The data took years to acquire and months to prepare, and the actual analysis took weeks and sometimes months for the largest datasets. The progression of PSA levels correlated so strongly with the danger from prostate cancer that it virtually jumped off the screen.

Now, a new phase begins for Thomas Neville, PhD, a Yale and Stanford-trained engineer and economist who worked in energy and helped build an international industrial combustion engineering company before a prostate cancer diagnosis drew him into medical research.

“When I first got involved with prostate cancer research, the results were so strong that I assumed they would have an immediate impact on screening practices,” Neville said. “I was naïvely optimistic, but that’s probably a good thing because it kept me going.”

Neville started down his current path in 2002, when his doctor called to say that a prostate biopsy had tested positive for cancer.

His doctor suggested several options, but Neville lacked the expertise to compare them, so he did what any well-educated individual would do: He reviewed the existing research.

Neville’s initial investigation provided far less certainty than he’d expected. Some evidence supported radical prostatectomy. Some supported radiation. Some supported active surveillance. Different experts further muddied the water with conflicting recommendations.

Still, Neville collected all the evidence he found and synthesized it as best he could, noting areas of consensus and evaluating the relative strengths of conflicting studies. He posted his findings online, updating his material as he went along. His latest material on prostate cancer can be found at ProstateSmart.info.

By the time Neville chose to undergo a radical prostatectomy, his work had reached a surprising number of grateful readers, readers who inspired Neville to supplement the treatment information with similar information about screening. Eventually, the lack of persuasive answers to relatively basic questions about screening inspired Neville to undertake new research.

With his wife Kelly, he also decided to turn his avocation into a business, and they founded a start-up company called Soar BioDynamics, Inc., near their home in North Lake Tahoe.

PSA

The observation that cancer tends to increase production of a protein called prostate-specific antigen (PSA) has made blood tests the primary way of finding the disease in asymptomatic men for the past 20 years. Indeed, during much of that time, many medical organizations recommended yearly PSA tests for men, starting at age 50.

Normal PSA levels vary considerably among men, but doctors have traditionally regarded PSA levels above 4.0 ng/mL with enough suspicion to consider performing a biopsy and making a definitive diagnosis.

Recent research, however, has challenged this reliance on PSA testing in a number of different ways. Studies have demonstrated that some prostate cancer victims have PSA levels below 4.0 ng/mL, while many cancer-free men have much higher concentrations of PSA in their blood. Other studies have found that early prostate cancer detection often does more harm than good. Men frequently overreact and choose to fight indolent tumors with treatments that can potentially result in serious side effects such as impotence and incontinence.

Such findings have led some experts to recommend against widespread yearly PSA testing, but it led Neville (and others) to ask a question: If doctors used data from many years’ of PSA tests rather than considering one test in isolation, could they detect cancer more reliably and gain some insight into its likely speed of progression?

Neville realized that he’d be regarded as a crazy dilettante unless he could attract some established collaborators, so he reached out to many of the experts who were doing related research.

“I was extremely fortunate to have had superb physicians care for me during my time as a patient, and we have stayed in touch. They are also top researchers. Peter Carroll is now associate dean of the School of Medicine and chief of Urology at UCSF, and Eric Klein is now chairman of the Glickman Urological and Kidney Institute at Cleveland Clinic,” Neville said. “But a lot of it is just knocking on doors and saying, ‘Hi. I’m Tom Neville.’ Sometimes folks slam the door in my face, but sometimes they let me in and I end up with a new resource.”

Continuing Success

Few people take on a new field as complicated as medical research after they become eligible for AARP membership, but Neville has demonstrated a wide range of talents over the course his life.


View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Community Practice Connections™: Personalized Sequencing in Castration-Resistant Prostate Cancer: Bridging the Latest Evidence to the Bedside in Clinical ManagementAug 25, 20181.5
Community Practice Connections™: Precision Medicine for Community Oncologists: Assessing the Role of Tumor-Testing Technologies in Cancer CareNov 30, 20181.0
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