Early scans to cut prostate cancer deaths

Early scans can save lives from prostate cancer. PICTURE: Supplied

Early scans can save lives from prostate cancer. PICTURE: Supplied

Published Jan 24, 2017

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The £315/R5295 screening test doubles the rate at which dangerous tumours are spotted. And it would slash the number of men subjected to painful biopsies by a quarter. The British trial has been welcomed as the biggest advance in prostate cancer diagnosis in 30 years. NHS officials are already examining the findings, which could herald a major change in the way middle-aged men are assessed for the disease.

Angela Culhane, of the charity Prostate Cancer UK, said: ‘This is the biggest leap forward in prostate cancer diagnosis in decades, with the potential to save many lives.’

Some 100,000 middle-aged men thought to be at risk of prostate cancer are given a biopsy every year, usually after a blood test has picked up raised levels of ‘prostate-specific antigen’, known as PSA.

But the procedure is notoriously painful, inaccurate and comes with a risk of side-effects including infections and bleeding.

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In a Government-funded trial of 576 men, led by University College London and involving 11 UK hospitals, experts found using an MRI scan before a biopsy had much better results.

According to the findings, published last night in the Lancet, doctors could immediately send 27 per cent of men home without needing a biopsy.

That would spare 27,000 British men a year the ordeal of unnecessary probes.

For the rest, doctors were able to conduct the biopsy with far greater accuracy, using the MRI scan to sample directly from suspect tissue rather than targeting a random area.

As a result, they were able to correctly diagnose 97 per cent of aggressive tumours, nearly double the 48 per cent correctly diagnosed with biopsy alone.

Some 47,000 men are diagnosed with prostate cancer in the UK each year, but the severity of the disease varies hugely.

Rapid treatment for men with aggressive forms of the cancer is vital.

Delays can prove deadly and 11,300 men die each year from the disease. Experts said many of these deaths could be avoided using the MRI scans as aggressive tumours could be picked up earlier and treated.

The scans could also reduce the number of men a year who are ‘overtreated’ undergoing unnecessary surgery or radiotherapy for small tumours that may never have turned dangerous.

Researchers calculated that scans could reduce the estimated figure of 20,000 by 5 per cent, sparing 1,000 men the ordeal.

Study leader Dr Hashim Ahmed, of University College London, called for MRI tests to be made available for all men.

He said: ‘Our study found that using the tests could reduce over-diagnosis of harmless cancers by 5 per cent, prevent one in four men having an unnecessary biopsy, and improve the detection of aggressive cancers from 48 per cent to 93 per cent.’

Fellow researcher Professor Mark Emberton said it was the biggest advance since PSA tests and biopsies were first widely used 30 years ago.

NHS watchdog NICE has been waiting for some time for the results of the trial and last night confirmed the findings would influence its guidance for prostate testing.

A spokesman said: ‘In light of new evidence we have decided to update some of the recommendations.’

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If guidelines were changed tomorrow, 32 per cent of men in Britain would be able to access a suitable MRI at their local hospital.

Protate Cancer UK admitted a roll-out would not happen overnight but said urgent action was ‘critical’.

At £315/ R5295 a scan, the technique is expensive, but this would be offset by reducing the number of biopsies, which cost £311/R5228 a time.

Professor Stephen Langley, consultant urological surgeon at the Royal Surrey County Hospital, said many urologists already use MRIs, but the new trial gives the technique the ‘seal of approval’.

He said: ‘I would like all urologists to be able to provide men with more clarity as to the stage of their disease and the treatments required if clinically significant cancer is detected, or the chance to avoid unnecessary biopsy if it is not.’

Health Secretary Jeremy Hunt hailed the study as another example of the Government’s commitment to making Britain world leaders in cancer care and research.

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