Study finds prostate cancer tests underestimate disease in half of cases

April 11, 2014

A study published in the British Journal of Cancer suggests that tests to grade and stage prostate cancer underestimated the severity of the disease in half of men whose cancers had been classified as 'slow growing'.

Scientists from the University of Cambridge compared the staging and grading of cancer in over 800 men before and after they had surgery to remove their prostate. They found that of the 415 men whose prostate cancer was classified as slow growing and confined to just the prostate after an initial biopsy, half (209) had cancer which was more aggressive than originally thought when assessed again after surgery and almost a third (131) had cancer that had spread beyond the prostate.

Greg Shaw, a urological surgeon and one of the study authors based at the Cancer Research UK Cambridge Institute, said: "Our results show that the severity of up to half of men's may be underestimated when relying on tests before they have surgery.

"This highlights the urgent need for better tests to define how aggressive a prostate cancer is from the outset, building on diagnostic tests like MRI scans and new biopsy techniques which help to more accurately define the extent of the prostate cancer. This would then enable us to counsel patients with more certainty whether the prostate cancer identified is suitable for or not.

"Whilst active surveillance would seem to be a safe approach for some men, nearly a third will end up needing surgery or radiotherapy within five years."

Prostate cancer is the most common cancer in men in the UK with around 41,700 new cases diagnosed every year. Last year there were around 10,800 deaths in the UK from prostate cancer. The severity of prostate cancers is assessed using biopsy, MRI and PSA tests.

Professor Malcolm Mason, Cancer Research UK's prostate expert, said: "Despite the limitations that this study shows, all evidence so far points to active surveillance being safe provided are carefully selected. But we need better methods of assigning a grade and stage so that no man has to unnecessarily undergo treatment, while at the same time making sure we detect and treat the cancers that really need it."

Explore further: Non-invasive imaging instead of repeated biopsy in active monitoring of prostate cancer

More information: Shaw, GL et al. "Identification of pathologically insignificant prostate cancer is not accurate in unscreened men." (2014) British Journal of Cancer

Related Stories

Non-invasive imaging instead of repeated biopsy in active monitoring of prostate cancer

April 6, 2014
Your body's cells have two major interconnected energy sources: the lipid metabolism and the glucose metabolism. Most cancers feed themselves by metabolizing glucose, and thus can be seen in Positron Emission Topography (PET) ...

Implications of very low risk prostate cancer assessed

September 20, 2013
(HealthDay)—The risk of adverse findings at surgery for men with very low risk (VLR) prostate cancer is significantly lower than for those with low risk (LR), according to research published in the October issue of the ...

New imaging approach fast tracks drug testing for incurable prostate cancer

March 17, 2014
Cancer Research UK-funded scientists have developed a new way to test the effectiveness of a drug for prostate cancer that has spread to the bone, which is currently incurable, according to research published in the Journal ...

Scientists finally discover which prostate cancers are life-threatening

November 19, 2013
Cancer Research UK scientists have discovered that the presence of a specific protein can distinguish between prostate cancers that are aggressive and need further treatment from those that may never seriously harm the patient.

Added prostate CA criteria may help ID surveillance candidates

January 24, 2014
(HealthDay)—Additional predictors, such as prostate-specific antigen (PSA) density and extent of cancer on biopsy, help guide selection of prostate cancer patients for active surveillance programs, according to research ...

Study: Surgery helps some prostate cancer patients

March 13, 2014
Surgery to remove the prostate saves lives compared to "watchful waiting" for some men whose cancers were found because they were causing symptoms, long-term results from a Scandinavian study suggest.

Recommended for you

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

How CD44s gives brain cancer a survival advantage

July 19, 2017
Understanding the mechanisms that give cancer cells the ability to survive and grow opens the possibility of developing improved treatments to control or cure the disease. In the case of glioblastoma multiforme, the deadliest ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.