A piece in the Times:
A simple home-testing kit could help to diagnose aggressive forms of prostate cancer up to five years earlier.
The kits will be sent to 2,000 men in the UK, Europe and Canada as part of a trial. The men will take two urine samples to return by post for lab analysis.
Teams from the University of East Anglia (UEA) and the Norfolk and Norwich University Hospital trialled the kit with a small group of participants before the latest phase of the study.
The aim of the Prostate Screening Box is to diagnose aggressive prostate cancer that will require treatment by looking at gene expressions in urine. In the pilot study it did so up to five years earlier than standard clinical methods, which means the need for invasive and uncomfortable tests would be reduced.
Dr Jeremy Clark, the lead researcher from Norwich medical school at UEA, said: “Prostate cancer is the most common cancer in men in the UK. However, it usually develops slowly and the majority of cancers will not require treatment in a man’s lifetime. It is not a simple matter to predict which tumours will become aggressive, making it hard to decide on treatment for many men.”
The most common tests for prostate cancer include blood tests, a physical examination known as a digital rectal examination, an MRI scan or a biopsy. The urine tests could make monitoring of cancer in men “so much less stressful for them and reduce the number of expensive trips to the hospital”, Clark said.
It works by picking up secretions from the prostate, just below the bladder, that naturally flow into the urethra and end up in urine. These carry cells and molecules from all over the prostate. The first of two urine samples is taken first thing in the morning, to include overnight secretions, and the second sample an hour later.
Clark said: “Feedback from early participants showed that the at-home collection was much preferred over sample collection in a hospital. We hope that using our Prostate Screening Box could in future revolutionise how those on ‘active surveillance’ are monitored for disease progression, with men only having to visit the clinic after a positive urine result.”
At present men with low-risk cancer and those on active surveillance are recalled to the clinic every six to twelve months for a range of tests including a digital rectal examination, biopsies and MRI.
Clark hopes that the urine tests could enable men with a negative test to be retested less frequently, every two to three years, “relieving stress to the patient and reducing hospital workload”.
Robert Mills, consultant clinical director in urology at Norfolk and Norwich University Hospital, said: “This simple, non-invasive urine test has the potential to significantly change how we diagnose and manage early prostate cancer for the benefit of patients and healthcare systems. It may enable us to avoid unnecessary diagnosis of low-risk disease as well as manage patients more appropriately with surveillance for those with low risk of progression, and early curative treatment for those at high risk of progression.”
The research has been funded by a Movember and Prostate Cancer UK innovation award, the Masonic Charitable Foundation, the Bob Champion Cancer Trust, the King family, the Andy Ripley Memorial Fund, the Hargrave Foundation, Norfolk Freemasons and the Tesco Centenary Grant.
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