Urine test for prostate cancer could spare thousands from having radical treatment

Thousands of men with prostate cancer may be spared painful treatments thanks to a new urine test, scientists say.

A trial of the experimental test showed it can spot the killer disease five years earlier than current methods.  

Researchers discovered it can also accurately predict whether patients will require treatment in the first five years of diagnosis. 

Prostate cancer is the most common cancer in men in the UK, with 47,000 men being diagnosed each year.

It usually develops slowly and the majority of cancers will not require treatment in a man’s lifetime. 

But doctors currently struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment. 

Active surveillance is a way of monitoring low-risk, localised prostate cancer using blood tests and scans every few months (file image)

Active surveillance is a way of monitoring low-risk, localised prostate cancer using blood tests and scans every few months (file image)

Aggressive forms of the disease require rapid treatment, but low-risk patients often do not need any treatment at all. 

Experts hope the test could help men avoid unnecessary biopsies and repeated invasive follow-ups for ‘low risk’ patients. 

The test, called PUR (Prostate Urine Risk), works by looking at genetic information stored within urine. 

A computer algorithm then identifies a combination of 35 genes that indicate how severe a patient’s cancer might be.  

It was developed by a team of researchers at the University of East Anglia (UEA) and the Norfolk and Norwich University Hospital (NNUH).

They analysed urine samples from 535 men to create the test before trialling it on 250 patients.

The results of the test were published today in the British Journal of Urology (BJU) International. 

Radiotherapy, while effective, is known to cause nausea, fatigue, erectile dysfunction and incontinence. 

Surgery to remove the prostate gland is painful and comes with similar side effects, charities warn.

During the uncomfortable prostate biopsy, a needle is used to collect a number of tissue samples from the prostate gland. Rectal bleeding and blood in semen is common after the procedure.  

Lead author Dr Jeremy Clark, from UEA’s Norwich Medical School, said: ‘This research shows that our urine test could be used to not only diagnose prostate cancer without the need for an invasive needle biopsy but to identify a patient’s level of risk. 

‘This means that we could predict whether or not prostate cancer patients already on active surveillance would require treatment.’ 

Robert Mills, consultant surgeon in urology at the Norfolk and Norwich University Hospital, said: ‘Currently diagnostic tests for prostate cancer are too non-specific to differentiate those without prostate cancer, those with low risk disease that is unlikely to be of clinical significance and those with disease that should be treated. 

‘This test has the potential to improve clinical decision making by helping to differentiate these three groups.’  

WHAT IS PROSTATE CANCER?

How many people does it kill?

Prostate cancer became a bigger killer than breast cancer for the first time, official statistics revealed last year. 

More than 11,800 men a year – or one every 45 minutes – are now killed by the disease in Britain, compared with about 11,400 women dying of breast cancer. 

How quickly does it develop? 

Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS

If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted. 

Some patients can be cured if the disease is treated in the early stages.

But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms. 

Tests and treatment

Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge. 

There is no national prostate screening programme as for years the tests have been too inaccurate.

Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.

Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.

But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof. 

Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks. 

Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org

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