David Rose
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A genetic test for prostate cancer, which should transform the way the disease is detected and monitored, is now available in Britain.
The test, the first of its kind, measures the activity of a gene closely linked to the cancer. Doctors hope that it will make diagnosis of the disease more accurate and reduce the number of biopsies removal of tissue samples that are obtained through painful procedures.
Prostate cancer is diagnosed in about 35,000 men each year in Britain and 10,000 die from the disease.
The standard diagnostic tool is the Prostate Specific Antigen (PSA) test, which looks for raised levels of a protein in the blood that leaks out of the prostate gland. But the PSA test is notorious for providing misleading results, which has led doctors to nickname it the “Producer of Stress and Anxiety” test.
The new test measures a genetic chemical, messenger RNA, which transfers DNA “instructions” from the PCA3 gene. Elevated scores are produced only when prostate cancer is present, making the test highly specific.
The Prostate Cancer charity said that the test could help doctors to decide whether or not to proceed with biopsies which, as well as being painful, can have unwanted side-effects.
“If the test indicates it is unlikely that the man has prostate cancer this reassures both the man and his doctor, and these repeat tests can be avoided,” Chris Hiley, a spokesman for the charity said.
Biopsies are performed by “punching out” small pieces of the prostate gland using a sharp needle inserted through the anus. The procedure causes acute anxiety in some patients and carries a risk of infection. In 80 per cent of cases, a biopsy produces a negative result, but this does not automatically exclude the presence of cancer.
Men with raised PSA, but who appear to be cancer-free, often have to undergo repeated biopsies to check that all is well. Offering the new PCA3 test could ensure that biopsies are carried out only when absolutely necessary.
The Progensa PCA3 test, which is licensed in the European Union, costs about £200 compared with about £10 for a PSA test. For this reason it is unlikely to be used as routinely as a PSA test and, at present, is not widely available on the NHS. However, offering it to NHS patients could theoretically reduce the cost of £500 biopsies.
A genetic test for breast cancer is also being heralded as a “big step forward” by scientists. It is hoped that it will be widely available on the NHS within months. The method, developed by researchers in Newcastle upon Tyne, could dramatically cut the cost and time it takes to test women for the BRCA1 gene, which carries with it an 80 per cent risk of breast cancer.
The new technology uses a Roche “genome sequencer” to test DNA for genetic abnormalities. It is already in use at the Institute of Human Genetics in Newcastle, and scientists there are validating the technique so that it can be rolled out more widely across the country in the next year.
John Burn, head of the institute, described the method as a “big step forward a breakthrough that is keeping us at the forefront of diagnostic testing. It takes us up to a whole new level, comparable to moving from horse-drawn carts to cars”.
He said that the new method was expected to make testing much more accessible to women at risk of inheriting breast cancer, which is the most common form of the disease in Britain.
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Having scoured the net for more information about this test, I echo the pleas of the other correspondents who ask for details of where one can get it in this country. Do BUPA offer it? There must be many like me who would like to have this done and the reaction of most GPs is likely to be negative. Could Dr Tom do a short piece about it?
RB
roger bird, Somerset,
Is this test available in Thailand?
L. Maddams, Bangkok, Thailand
Interesting article but more information regarding availability in UK, would have been of benefit. Is this test available in the private sector ( ie; Bupa and others) if not on the NHS ?
Please advise search direction.
PT, bideford,
I have seen references elewhere to this test being used to avoid the need for repeat biopsies. Why repeat ? Can it not be used to determine whether any biopsy is needed, such as the first!
John, Hove,
Does the new Prostate test differentiate between the mild and agressive forms of cancer? We know that most men die with the cancer than from it so will this test be able to help here?
Jim Baker, Aylesbury, UK
What about giving us an address, clinic, doctor and phone number to contact for this gene test? It's no good just to say that it's available. If you are going to put out info, put it all out!!
James Morgan, Brighstone, I.O.W,, England