Inadequate Cancer Test Puts Men’s Health at Risk
Britain’s top cancer scientists claim that men’s health
is at risk because the current test for prostate cancer is inadequate.
The warning comes as The Institute of Cancer Research launches the 7th
Everyman Male Cancer Awareness Month to alert men to the risk of prostate
and testicular cancer.
With research into male cancers still 10 years behind other cancers,
the Everyman scientists are calling for £500,000 to help fund their
research into developing better methods of testing men for prostate cancer.
Prostate cancer is now the most common cancer to affect men in the UK,
with 27,000 diagnosed each year, and one man dying from the disease each
hour.
Recent research shows that half of all men who are diagnosed with prostate
cancer by PSA testing do not need any treatment at all for their cancer,
but the PSA test is incapable of discriminating between those who do
need treatment and those who do not.
The controversial PSA test is currently the only method of screening
for early prostate cancer, but many doctors believe it to be too unreliable
to recommend to patients routinely.
Professor Colin Cooper, Head of the Everyman Male Cancer Research Centre
at The Institute of Cancer Research comments:
“PSA testing has two major failings; firstly it doesn’t
detect all cancers, and secondly when it does detect cancer it cannot
predict how that cancer will behave. This often results in men being
given invasive treatment that they do not require. What we
urgently need is a test which can differentiate between cancers that are aggressive,
the tigers, and those that are pussycats, but meantime PSA is the best we’ve
got.”
Treatment options for prostate cancer most commonly include the removal
of the prostate (prostatectomy), radiotherapy and hormone treatment,
but these treatments can leave the patient with serious long-term side
effects that can include incontinence and impotence. So ideally, such
treatment would be restricted only to the 50% of prostate cancer patients
who need it.
Dr Chris Parker of The Institute of Cancer Research comments:
“Prostate cancer is the only human cancer that is curable but
which commonly does not need to be cured. It can often be so slow growing
as to never cause the patient any ill effects. So it can be a case of
the cure being worse than the disease. The challenge is to identify who
needs to be treated and who doesn’t.”
By the age of 65, many men will have some cancer cells in the prostate,
but most will live out their natural span without the disease ever causing
them any ill effects. This presents patients with the dilemma of whether
or not to go for treatments which carry a real risk of incontinence and
impotence.
In the United States men over 50 are routinely given PSA tests during
health checks with more than half having a test each year. This level
of testing has led to the incidence of prostate cancer in the USA more
than doubling since the introduction of screening. The standard approach
in the US is to offer radical treatment to all men with localised disease,
resulting in up to 50% being over treated and subjected to significant
risks of incontinence and impotence. Without a new prostate cancer test,
this trend for PSA testing looks set to continue, and treating all cases
in this way will become increasingly difficult to justify.
Dr Chris Parker at The Institute of Cancer Research is currently conducting
a study of a new approach for men with early prostate cancer called Active
Surveillance. Any men whose tumours show early signs of growth are treated,
but the rest continue on the surveillance programme with no ill effects
from the disease and no need for
treatment. Early results of the Active Surveillance programme suggest that
two thirds of selected patients may be safely spared invasive treatment for
their prostate cancer.
Professor Peter Rigby, Chief Executive of The Institute of Cancer Research
concludes:
“At the moment we simply don’t know what causes prostate
cancer. We desperately need more funds to enable us to carry out that
research, and to develop a test which can distinguish between the pussycats
and the tigers, between those men who can be spared treatment, and those
with an aggressive cancer who need to have life saving treatment to beat
the disease.”
Notes to Editors
- PSA (Prostate Specific Antigen) is a protein made by the prostate gland,
which leaks into the bloodstream naturally. Sometimes a raised PSA
level can be a sign of prostate cancer. More often, it is caused by
something less serious like an inflamed prostate (prostatitis) or an
enlargement of the prostate that comes with ageing (benign prostatic
hypertrophy). A single PSA test cannot show you whether a prostate
cancer is present, or whether it is slow or fast growing.
- ‘
Active Surveillance’ aims to individualise therapy by selecting
only those men with significant cancers for radical treatment. Men
who, in the past would have had either surgery or radiotherapy, are
closely
monitored with frequent PSA tests and with repeat prostate biopsies.
The choice between radical treatment or continued observation is based
on evidence of progression during this initial monitoring.
- Everyman is The Institute of Cancer Research’s campaign to raise
awareness of and funding for research in prostate and testicular cancers.
The Institute has built Europe’s first dedicated Male Cancer
Research Centre
The Institute of Cancer Research needs to raise £2m each year
to support the pioneering research in the Everyman Centre.
- The Institute
is a charity that relies on voluntary income. The Institute is a highly
cost-effective major cancer research organisation with
over 90p in every £ directly supporting research.
- The Institute
of Cancer Research is a centre of excellence with leading scientists
working on cutting edge research. It was founded in 1909
to carry out research into the causes of cancer and to develop new
strategies
for its prevention, diagnosis, treatment and care.
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