As Prostate Cancer Awareness Month 2017 draws to a close, associate Arran Macleod provides an update on developments in prostate cancer diagnosis techniques, which he initially explored in an article on the new breakthrough test for prostate cancer published at the start of this year’s awareness campaign.
About 46,000 British men are diagnosed with prostate cancer each year through biopsies prompted by a high prostate specific antigen (PSA) blood test score. 11,000 men die each year from the disease.
The traditional method of diagnosing prostate cancer, by way of invasive prostate biopsies, is not completely accurate and a recent trial showed that pre-biopsy MRI scans are almost 100% more effective. The reason for this is that biopsies are not targeted at specific areas of the prostate, causing either the presence of cancer to be missed completely or leading to patients being over-treated to counter the risk of under-diagnosis.
The trial, carried out at University College London, has been described as the biggest advance for decades in diagnosing the disease and a similar research trial in the Netherlands has also found that MRIs were as good at detecting the most dangerous cancers as prostate biopsies.
The NHS has clearly taken heed of the recent findings and is now reportedly working to make sure that all hospitals have the ability to carry out MRI screening scans for patients referred with abnormal PSA levels.
The next stage could be to implement a national screening programme, which would be similar to the NHS breast cancer detection programme. This would allow patients with rising PSA scores to be routinely screened and may enable earlier diagnosis and more appropriate treatment plans. Patients screened who do not have prostate cancer would be spared an invasive procedure and those with early onset disease would be treated appropriately for its aggressiveness. It is thought a screening programme could cut deaths by 20% per year and save thousands of men being made impotent or incontinent by unnecessary treatment.
Heather Blake, of Prostate Cancer UK, said that MRI screening was ‘an exciting possibility’. However, she warned of issues relating to cost and resource as a barrier to this technique’s implementation.
Arran Macleod, a member of the clinical negligence team at Penningtons Manches LLP, said: “Many hospitals already utilise MRI scans due to their now proven diagnostic ability. However, it is encouraging to hear that the NHS is taking steps to implement pre-biopsy MRI scanning in all hospitals across the UK. Prostate cancer is one of the largest causes of death among males in the UK and MRI scanning should enable more accurate diagnosis and more appropriate treatment plans to be implemented.
“We often see in our work the physical and emotional harm suffered by patients whose prostate cancer has been under-diagnosed and under-treated, diagnosed later than it should have been, or missed completely. The team at Penningtons Manches welcomes the implementation of MRI scanning for this disease, which should increase the timing and accuracy of diagnosis and, ultimately, improve patient safety.”