Gene test for aggressive prostate cancer
21st February 2014 -- Screening men with a family history of prostate cancer for genetic mutations can identify those who are at high risk of aggressive forms of the disease, according to a new UK study.
Current prostate cancer tests can't differentiate between slower growing cancers that probably won't cause any harm and aggressive ones that can be deadly.
A similar approach with breast cancer has helped to target treatment better.
Prostate cancer is the most common cancer in men in the UK.
Currently there is no organised NHS screening programme for prostate cancer because of a lack of reliable testing and the risk of unnecessary treatment because of 'false positive' prostate specific antigen (PSA) test results.
Predicting prostate cancer development
Scientists at The Institute of Cancer Research in London looked at the genes of men who had several relatives with prostate cancer, who they expect to be at a higher risk of the cancer themselves. They analysed blood samples from 191 men with prostate cancer at several UK cancer centres using the latest rapid genetic screening techniques.
They were able to highlight 14 men with mutations in cancer genes that predicted the development of the disease.
The findings, reported in the British Journal of Cancer, show some men have a genetic profile putting them at a higher risk of prostate cancer, and that specific genetic profiles suggest a higher risk of developing advanced and invasive prostate cancer.
The researchers identified 13 mutations which prevent the genes from producing a properly working protein in 8 DNA repair genes. The genes tested for were BRCA1 and BRCA2, which are already routinely tested for in women with a strong family history of breast or ovarian cancer, plus ATM, CHEK2, BRIP1, MUTYH, PALB2 and PMS2.
Men with any of these mutations were much more likely than those without them to go on and develop advanced prostate cancer that would spread to other parts of the body.
The gene testing is still some way off being used for prostate cancer in the same way as breast cancer. However, study co-leader Professor Ros Eeles, professor of oncogenics at The Institute of Cancer Research, London, and Honorary Consultant at The Royal Marsden NHS Foundation Trust says in a statement: "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.
Fellow study co-leader Dr Zsofia Kote-Jarai, senior staff scientist at The Institute of Cancer Research, London, adds: "One of the important messages to come out of our study is that mutations to at least 8 genes, and probably many more, greatly increase the risk of aggressive prostate cancer. Any future screening programme would need to assess as many of these genes as possible – more than we currently look for in women at risk of breast cancer, for example."