Prostate tests on men without symptoms could save thousands

A UK proceedings wherever men who had nary symptoms were screened for prostate cancer recovered hundreds had life-threatening forms of the illness which mightiness different not person been spotted successful time, Good Health tin reveal.

If the trial, which was confined to 2 counties successful England, had been extended to the full country, ‘thousands more’ men with prostate crab who mightiness different dice of the illness could perchance person been detected, says Stephen Langley, a prof of urology astatine the Royal Surrey County Hospital, Guildford, and co-chairman successful urology of the Surrey & Sussex Cancer Alliance – which led the study.

Professor Langley says he’s ‘very hopeful’ the results, which amusement that targeted screening is effective, volition adhd to the lawsuit for a nationwide programme aimed astatine men whose property oregon household past puts them astatine higher hazard of the disease.

Prostate crab is present the astir communal crab successful England, with 55,000 caller cases diagnosed each year. It is liable for 12,000 deaths annually, but determination is nary screening for it adjacent though it’s usually symptomless successful aboriginal stages.

Currently 45 per cent of prostate crab cases are diagnosed astatine a precocious signifier erstwhile it is harder to dainty and whitethorn person spread. By examination successful bosom crab – which women are screened for from the property of 50 – 26.9 per cent of cases are spotted astatine this aboriginal stage, according to Cancer Research UK figures.

For the caller study, 18,000 men without immoderate symptoms of prostate crab were archetypal fixed a humor trial to cheque levels of prostate-specific antigen (PSA), a macromolecule made by the prostate – raised levels tin beryllium a motion of cancer.

Men were contacted by substance having been selected from the database of 50 GP surgeries successful the Surrey and Sussex area.

They were directed to a website which invited them for a humor trial conducted by Medefer, an online healthcare company.

The men included were aged 50-70, achromatic men aged 45-70 (who person astir treble the hazard of prostate cancer) oregon those whose household past of crab enactment them astatine hazard (as good arsenic prostate cancer, this includes having pistillate relatives with a past of bosom crab related to BRCA cistron mutations).

The men were advised to debar enactment oregon strenuous lifting for 3 days beforehand, some of which tin rise PSA, and were fixed a urine trial to cheque for infection, which tin besides origin PSA levels to rise.

Just nether 5 per cent (4.7 per cent oregon 865 men) were recovered to person a raised PSA (generally speaking, either implicit 3ng/ml oregon depending connected property from 2.5ng/ml to 6.5ng/ml) – they were past sent for an MRI scan for elaborate images of the prostate: 343 of these men were past referred for a biopsy and 64 per cent of them (221 men successful full oregon 1.2 per cent of the full tested) were recovered to person ‘life-threatening’ forms of the disease.

‘And this is among men who person nary symptoms,’ says Professor Langley, who presented the results of the Targeted Prostate Health Check, which is the archetypal NHS-funded targeted screening programme to beryllium tried successful this country, astatine the European Urology Association gathering successful Madrid past week. The results person present been submitted for work successful a journal.

He believes the attack utilized successful the 18-month proceedings could easy beryllium rolled retired passim the UK, with these targeted men re-tested each 2 to 3 years and with humor tests performed astatine GP surgeries oregon via mobile vans.

The determination astir whether to follow screening nationwide falls to the UK National Screening Committee, which has antecedently rejected it owed to the inaccuracy of PSA arsenic a measure, but it is reviewing this, and is owed to study aboriginal this year.

PSA whitethorn springiness emergence to mendacious positives and pb to the ‘over-diagnosis’ of cancers that whitethorn not beryllium a large menace to health.

‘There are galore reasons PSA tin beryllium raised – simply having a bigger prostate tin propulsion up the levels, yet antecedently each antheral who had a raised PSA would beryllium sent for biopsy [which tin beryllium uncomfortable and carries a hazard of infection] and we were uncovering what whitethorn beryllium insignificant cancers that would not beryllium a large threat,’ says Professor Langley.

‘But the MRI is the existent gamechanger successful this programme. It tin assistance america find who truly does request a biopsy and who doesn’t,’ helium adds. He believes the targeted screening attack ‘could assistance prevention galore men’s lives and I judge would extremity up being cheaper than treating late-stage prostate crab arsenic we presently do’.

Being selected to instrumentality portion successful the proceedings was life-saving for retired technologist Richard Flashman, 68, arsenic successful December 2022 it revealed helium had an assertive signifier of prostate cancer.

‘It’s a existent daze to beryllium told you person crab erstwhile you don’t consciousness unwell,’ says Richard, a begetter of three, who lives with woman Caroline, 68, a retired solicitor, successful Guildford, Surrey. ‘I felt truthful acceptable and steadfast and was starring an active, outdoor life.’

After getting a telephone to accidental his PSA astatine 3.8 warranted an MRI, to Richard’s utter daze this revealed helium had 2 tumours successful his prostate. A biopsy graded his crab arsenic a 9 (out of a imaginable 10) connected the Gleason people which rates a cancer’s aggression and likelihood to spread.

He opted for radiotherapy and hormone attraction alternatively than hazard side-effects specified arsenic impotence, which tin travel country to region the prostate.

He says: ‘I’m good present and each my functions are settling backmost to mean aft the treatment. But if it wasn’t for screening there’s each accidental that the crab would person dispersed and would person been untreatable by the clip I got symptoms.’

Amy Rylance, adjunct manager of wellness betterment astatine Prostate Cancer UK, said the results of the caller proceedings ‘are precise encouraging – some that ample numbers of men came guardant for screening and that the task successfully identified hundreds of life-threatening cancers successful clip for a cure’.

Tim Dudderidge, a advisor urological surgeon based successful Southampton, besides welcomed the results. ‘Broadly, I bash deliberation screening done with an MRI being the triage for a biopsy identifies lethal cancers without excessively diagnosing the ones we don’t truly request to cognize about,’ helium says. But helium adds: ‘The National Screening Committee has well-developed technological thresholds for processing screening and they judge we request different proceedings to find the champion approach.’