A new urine test can diagnose prostate cancer and cut the need for risky biopsies by a third.
British scientists have developed the revolutionary test and researchers showed the pregnancy test-like ‘ExoGrail’ device could reduce unnecessary biopsies by 35%.
A prostate biopsy involves using thin needles to take small samples of tissue from the gland.
The tissue is then looked at under a microscope to check for cancer. If cancer is found, the biopsy results will show how aggressive it is – how likely it is to spread outside the prostate.
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Biopsies can have side effects and risks such as triggering a serious infection.
They can also pick up a slow growing or non-aggressive tumours that might not cause any symptoms or problems in the patient’s lifetime.
If a decision is then taken to operate to remove the prostate it can leave men incontinent or impotent.
Lead researcher Dr Dan Brewer, from the University of East Anglia, said: “While prostate cancer is responsible for a large proportion of all male cancer deaths, it is more commonly a disease men die with rather than from.
“Therefore, there is a desperate need for improvements in diagnosing and predicting outcomes for prostate cancer patients to minimise over-diagnosis and overtreatment whilst appropriately treating men with aggressive disease, especially if this can be done without taking an invasive biopsy.
“Invasive biopsies come at considerable economic, psychological and societal cost to patients and healthcare systems alike.”
Prostate cancer kills more men than any other cancer claiming around 12,000 lives a year.
The most commonly used tests include blood tests, a physical examination known as a digital rectal examination (DRE), an MRI scan or a biopsy.
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Doctors struggle to predict which tumours will become aggressive, making it hard to decide on treatment for many men.
ExoGrail detects protein-marker called EN2 and the levels of gene expression of 10 genes related to prostate cancer risk. It builds on two previously developed tests called PUR and ExoMeth.
Scientists tested it using urine samples from 207 patients who had been undergone a biopsy for prostate cancer at the Norfolk and Norwich University Hospital (NNUH).
When the urine results were compared to biopsy results, the study showed that the test had successfully shown which patients had prostate cancer and which did not.
The ExoGrail test also highlighted those for which an invasive biopsy would have been beneficial to get a better idea of how aggressive the tumour was.
Dr Brewer said: “Our new urine test not only shows whether a patient has prostate cancer, but it importantly shows how aggressive the disease is.
“This allows patients and doctors to select the correct treatment.”
Paul Villanti, executive director at Movember, said: “Having non-invasive tests which can accurately show how aggressive a man’s prostate cancer is not only reduces the number of men having to undergo painful biopsies, but also ensures that the right course of treatment for the patient is selected more quickly.”