Posted by: Tony Carson | 21 September, 2007

Genetic test for prostate cancer

Prostate cancer is a major killer

A genetic test which can detect signs of prostate cancer in urine has been launched in the UK.

It could make the diagnosis of the disease more accurate and reduce unnecessary biopsies in some men. See BBCs: Genetic test for prostate cancer.

The current test, which measures raised levels of a specific protein in the blood, is notoriously unreliable and can cause a lot of anxiety.

At £200 the genetic test is unlikely to be used routinely in the NHS and may be reserved for high-risk patients.

Diagnosis of prostate cancer can be difficult.

If the test indicates it is unlikely that the man has prostate cancer this reassures both the man and his doctor, and these repeat tests can be avoided 

Dr Chris Hiley, The Prostate Cancer charity

Doctors use the prostate specific antigen (PSA) test, which looks for raised levels of a protein in the blood that leaks out of the prostate gland.

A high PSA score indicates cancer may be present but to know more doctors have to take tissue samples from the prostate using a sharp needle through the anus.

But some men with cancer might have low PSA levels and go undetected while others without cancer may have high levels and end up undergoing procedures they did not need.

And men with raised PSA but who appear to be cancer-free often have to undergo repeated biopsies, to check that all is well.

The Progensa test, developed by Gen-Probe, measures the activity of a gene closely linked to prostate cancer – PCA3.

In the UK, about 73 men out of every 1,000 get prostate cancer at some point in their lives

63% of cases are in men aged 70 and over

If you have a relative diagnosed with prostate cancer you are at double the risk of getting the disease

It is elevated only in cancerous prostate tissue, making it a more specific indicator of cancer than PSA.

About 35,000 men are diagnosed with prostate cancer each year in the UK and 10,000 die from the disease.

The test is unlikely to be used routinely as it costs £200 compared with just £10 for a PSA test but one potential use is for those with a strong family history of the disease.

Professor Roger Kirby, from the London Prostate Cancer Treatment Centre, said the biggest worry in prostate cancer diagnosis is the uncertainty that surrounds a raised PSA level and any test which could reduce unnecessary biopsies was good news.

He added: “What we really would like to know is which of these cancers we’re diagnosing really need to be treated.

“There’s some data to suggest that PCA3 gives us a better handle on that.”

Dr Chris Hiley, head of policy and research management at The Prostate Cancer Charity, said for some men the test would help doctors decide whether or not to proceed with more biopsies, which can be painful and can have unwanted side effects.

“If the test indicates it is unlikely that the man has prostate cancer this reassures both the man and his doctor, and these repeat tests can be avoided.”

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