Screening for prostate cancer moves step closer

Scientists tested blood samples from 191 British men with prostate cancer who had at least three relatives affected by the disease.

Fourteen carried “loss of function” mutations in their DNA that completely stopped a gene working. Having any one of these flaws dramatically boosted the chances of developing invasive, spreading prostate cancer.

In future, men could be tested for the variants in the same way that women are currently screened for breast cancer genes, the researchers believe. This would herald a revolution in prostate cancer diagnosis and treatment.

Professor Ros Eeles, from London’s Institute of Cancer Research (ICR) and The Royal Marsden NHS Foundation Trust, said: “Our study shows the potential benefit of putting prostate cancer on a par with cancers such as breast cancer when it comes to genetic testing.

“Although ours was a small, first-stage study, we proved that testing for known cancer mutations can pick out men who are destined to have a more aggressive form of prostate cancer.

“We already have the technical capabilities to assess men for multiple mutations at once, so all that remains is for us to do further work to prove that picking up dangerous mutations early can save lives. If so, then in the future, genetic testing may be needed as part of the prostate cancer care pathway.”

Women with a strong family history of breast cancer are routinely tested for BRCA1 and BRCA2 gene defects, both of which greatly increase their chances of developing the disease.

Prostate cancer, however, seems to be linked to many different genetic mutations. Currently, there is no way of screening men who might be at risk from ferocious “tiger” prostate cancers.

Many diagnosed prostate cancers, known as “pussycats”, are slow-growing and can safely be left untreated while their progress is monitored.

An effective screening test would make it possible to step in early and treat men with developing, dangerous cancers before they progress too far.

Despite big advances in treatment in the last 10 to 20 years, around 11,000 of the 40,000 men diagnosed with prostate cancer each year in the UK die from the disease.

The ICR scientists used cutting-edge DNA sequencing technology to assess 22 known cancer genes at the same time.

The findings are reported in the latest edition of the British Journal of Cancer.

Dr Iain Frame, director of research at Prostate Cancer UK, said: “The minefield of prostate cancer diagnosis is one of the biggest hurdles facing treatment of the disease today.

“Current tests fail to differentiate between aggressive cancers that could go on to kill, and cancers that may never cause any harm. This lack of clarity means that too often men and their doctors are left having to make incredibly difficult decisions on whether to treat the disease or not.

“We urgently need to understand more about which men are at risk of developing prostate cancer and in particular aggressive forms of the disease.”