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'Huge leap' in prostate cancer testing | 'Huge leap' in prostate cancer testing |
(about 1 hour later) | |
The biggest leap in diagnosing prostate cancer "in decades" has been made using new scanning equipment, say doctors and campaigners. | The biggest leap in diagnosing prostate cancer "in decades" has been made using new scanning equipment, say doctors and campaigners. |
Using advanced MRI nearly doubles the number of aggressive tumours that are caught. | Using advanced MRI nearly doubles the number of aggressive tumours that are caught. |
And the trial on 576 men, published in the Lancet, showed more than a quarter could be spared invasive biopsies, which can lead to severe side-effects. | And the trial on 576 men, published in the Lancet, showed more than a quarter could be spared invasive biopsies, which can lead to severe side-effects. |
The NHS is already reviewing whether the scans can be introduced widely. | The NHS is already reviewing whether the scans can be introduced widely. |
Prostate cancer is the most common cancer in British men, and yet testing for it is far from perfect. | Prostate cancer is the most common cancer in British men, and yet testing for it is far from perfect. |
If men have high prostate specific antigen (PSA) levels in the blood, they go for a biopsy. | If men have high prostate specific antigen (PSA) levels in the blood, they go for a biopsy. |
Twelve needles then take random samples from the whole of the prostate. | Twelve needles then take random samples from the whole of the prostate. |
It can miss a cancer that is there, fail to spot whether it is aggressive, and cause side-effects including bleeding, serious infections and erectile dysfunction. | It can miss a cancer that is there, fail to spot whether it is aggressive, and cause side-effects including bleeding, serious infections and erectile dysfunction. |
"Taking a random biopsy from the breast would not be accepted, but we accept that in prostate," said Dr Hashim Ahmed, a consultant and one of the researchers. | "Taking a random biopsy from the breast would not be accepted, but we accept that in prostate," said Dr Hashim Ahmed, a consultant and one of the researchers. |
Around 100,000 to 120,000 men go through this every year in the UK. | |
Scanning | Scanning |
The trial, at 11 hospitals in the UK, used multi-parametric MRI on men with high PSA levels. | The trial, at 11 hospitals in the UK, used multi-parametric MRI on men with high PSA levels. |
It showed 27% of the men did not need a biopsy at all. | It showed 27% of the men did not need a biopsy at all. |
And 93% of aggressive cancers were detected by using the MRI scan to guide the biopsy compared with just 48% when the biopsy was done at random. | And 93% of aggressive cancers were detected by using the MRI scan to guide the biopsy compared with just 48% when the biopsy was done at random. |
Dr Ahmed, who works at University College London Hospitals, told the BBC News website: "This is a significant step-change in the way we diagnose prostate cancer. | Dr Ahmed, who works at University College London Hospitals, told the BBC News website: "This is a significant step-change in the way we diagnose prostate cancer. |
"We have to look at the long-term survival, but in my opinion by improving the detection of important cancers that are currently missed we could see a considerable impact. | "We have to look at the long-term survival, but in my opinion by improving the detection of important cancers that are currently missed we could see a considerable impact. |
"But that will need to be evaluated in future studies, and we may have to wait 10 to 15 years." | "But that will need to be evaluated in future studies, and we may have to wait 10 to 15 years." |
Chris, 70, from Hassocks, West Sussex | Chris, 70, from Hassocks, West Sussex |
Chris first noticed the symptoms at the theatre a decade ago, when he needed to go to the toilet repeatedly. | Chris first noticed the symptoms at the theatre a decade ago, when he needed to go to the toilet repeatedly. |
Doctors found his prostate was enlarged. | Doctors found his prostate was enlarged. |
In May last year, Chris needed to see his doctor again, as he was feeling tired a lot of the time. | In May last year, Chris needed to see his doctor again, as he was feeling tired a lot of the time. |
Prostate cancer was suspected, and he was offered an MRI scan as part of the trial. | Prostate cancer was suspected, and he was offered an MRI scan as part of the trial. |
He says: "I'd heard from a friend that a prostate biopsy could be extremely painful and uncomfortable, so was pleased to know that I wouldn't be sent for one unless the doctors were confident I needed it." | He says: "I'd heard from a friend that a prostate biopsy could be extremely painful and uncomfortable, so was pleased to know that I wouldn't be sent for one unless the doctors were confident I needed it." |
In the end, he still needed a biopsy, and he was diagnosed with a cancer that had not spread out of the tumour. | In the end, he still needed a biopsy, and he was diagnosed with a cancer that had not spread out of the tumour. |
He is now considering what to do about treatment. | He is now considering what to do about treatment. |
Angela Culhane, the chief executive at Prostate Cancer UK, described the current system of testing as "notoriously imperfect". | Angela Culhane, the chief executive at Prostate Cancer UK, described the current system of testing as "notoriously imperfect". |
She added: "This is the biggest leap forward in prostate cancer diagnosis in decades." | She added: "This is the biggest leap forward in prostate cancer diagnosis in decades." |
The study, led by the Medical Research Council Clinical Trials Unit, is already being considered by the National Institute for Health and Care Excellence. | |
It will decide whether the NHS can afford multi-parametric MRI for prostate cancer. | |
Each scan costs between £350 and £450 pounds per patient - so introducing them for all patients across the UK would have a bill around the £40m mark. | |
But each biopsy costs the NHS £450 so reducing the number would deliver savings. Catching aggressive cancers earlier could also deliver savings as could not treating patients with very low-risk cancers. | |
A full cost-effectiveness analysis is being carried out. | |
Prof Ros Eeles, from the Institute of Cancer Research in London, said the study was "very important" and "provides ground breaking data". | Prof Ros Eeles, from the Institute of Cancer Research in London, said the study was "very important" and "provides ground breaking data". |
The chairman of the British Society of Urogenital Radiology, Dr Philip Haslam, said: "Today's findings represent a huge leap forward in prostate cancer diagnosis." | The chairman of the British Society of Urogenital Radiology, Dr Philip Haslam, said: "Today's findings represent a huge leap forward in prostate cancer diagnosis." |
However, he warned the biggest issue could be the number of scanners and training people to interpret the results. | However, he warned the biggest issue could be the number of scanners and training people to interpret the results. |
Follow James on Twitter. | Follow James on Twitter. |
Have you been affected by prostate cancer? What is your reaction to the test advance? You can share your experience by emailing haveyoursay@bbc.co.uk. | Have you been affected by prostate cancer? What is your reaction to the test advance? You can share your experience by emailing haveyoursay@bbc.co.uk. |
Please include a contact number if you are willing to speak to a BBC journalist. You can also contact us in the following ways: | Please include a contact number if you are willing to speak to a BBC journalist. You can also contact us in the following ways: |
Or use the form below | Or use the form below |