A genetic screening test could help doctors to identify men with the most aggressive types of prostate cancer, UK scientists believe. The test could save men with milder forms of the disease from unnecessary surgery and its potentially serious side effects.
The study, published in the journal Lancet Oncology, looked at a set of 31 genes involved in cell cycle progression (CCP) - a process which promotes cell growth. The researchers found that specific combinations of CCP genes were more highly expressed in men with the most aggressive forms of prostate cancer.
'Our findings have great potential', said Professor Jack Cuzick, who led the research at Queen Mary, University of London. 'CCP genes are expressed at higher levels in actively growing cells, so we could be indirectly measuring the growth rate and inherent aggressiveness of the tumour through a test'.
In the UK, 37,000 men are diagnosed with prostate cancer and 10,000 die from the disease each year. Doctors currently have few reliable tools to help them distinguish between men with relatively harmless, slow-growing tumours and men with more aggressive, fast-growing tumours. This means that men with milder forms of the disease are often put through invasive surgical treatments unnecessarily.
'We already know that CCP levels can predict survival for breast and, more recently, brain and lung cancers. It's really encouraging that this could also be applied to prostate cancer, where we desperately need a way to predict how aggressive the disease will be', said Professor Cuzick.
703 men were involved in the research, half were from the United States (US) and had undergone surgery to remove the prostate, half were from the UK and were judged not to need immediate treatment. Not only could a high CCP level identify those in the UK group with more severe tumours that were likely to spread beyond the prostate, it could also identify those at risk of a relapse in the US group.
Dr Lesley Walker, from Cancer Research UK who funded the study, said: 'This is important research that could one day help solve one of the biggest problems in prostate cancer treatment. For some men, detecting prostate cancer early could be lifesaving. For others, it could mean unnecessary treatment and serious side effects'.
Further work is needed to confirm these results, but researchers hope that the test could be used clinically on prostate cancer patients within a year.
'This test isn't yet available for routine use, but we'll look forward to seeing the results of large clinical trials that will tell us whether it'll be useful for all men with prostate cancer', said Dr Walker.