A simple 10-minute scan reveals twice as many serious prostate cancer cases as existing blood tests, research published today shows.
Doctors currently use a blood test for prostate-specific antigen (PSA) to identify cases, but the rapid MRI scan yields far better results, according to the study.
Under current guidelines, men with a PSA level below 3 nanograms per milliliter are considered to be at low risk for prostate cancer and would not be referred for further testing.
But in the study, more than half of the men who had an abnormality on MRI and who were subsequently diagnosed with severe prostate cancer had a PSA below 3.
The study was also the first to measure PSA “density” — a number based on a blood test’s PSA level compared to the volume of the prostate gland.
Terry Noonan, 64, took part in the study and found he had aggressive cancer. His prostate was removed within weeks and he is now cancer free
“I was very fortunate to attend the trial”
Retired accountant Terry Noonan was 61 when his GP suggested he take part in a study to see if a 10-minute MRI scan was better than the standard PSA blood test in diagnosing prostate cancer.
Mr Noonan’s scan at University College London Hospital in November 2020 revealed he was at risk. His PSA density — a new screening measure that combines a man’s PSA level with the volume of the prostate gland measured on an MRI scan — was also elevated.
Further testing confirmed he had an aggressive cancer. His prostate was removed within weeks and he is now cancer free. Mr Noonan, 64, said: “I’m very lucky – the treatment was a complete success.”
Experts believe this to be more true because PSA levels and the size of the prostate naturally increase with age.
The standard PSA test can result in older men being falsely informed that they are at risk because their PSA levels are elevated.
Scientists involved in the study, called Reimagine, believe the 10-minute MRI combined with testing PSA density could revolutionize prostate cancer diagnosis and potentially lead to a national screening program for the disease.
Caroline Moore, Professor of Urology at University College London and Consultant at University College London Hospital, who led the research, said: “It was estimated that more than half of men with clinically significant cancer had a PSA level of less than 3ng /ml had – and would have done.’ confirming they did not have cancer – is sobering and reinforces the need to consider a new approach to early detection.
“Our results provide a first indication that MRI could be a more reliable method for the early detection of potentially serious cancers.”
Every year in the UK 52,000 men are diagnosed with cancer and more than 12,000 die from it.
The standard PSA test remains the most common way to determine who needs further testing, although the testing is unreliable, leading to some performing unnecessary testing and delaying the diagnosis of cancer patients.
In the new study, 303 men aged 50 to 75 underwent a 10-minute MRI scan of the prostate and a PSA density test.
(Stock Photo) The use of a rapid MRI scan yields far better results in identifying cases than the prostate-specific antigen (PSA) blood test, according to the study.
According to MRI, 16 percent – 48 men – were at risk of cancer, but two-thirds of these men had a PSA below 3.
More detailed scans showed that 25 of those men had cancer severe enough to require treatment, and 15 of them would not have been detected with a standard PSA test.
Separately, the PSA density test identified another 16 men at risk for prostate cancer, four of whom turned out to have the disease severe enough to require treatment.
Simon Grieveson, deputy director of research at charity Prostate Cancer UK, said the results were “extremely exciting”, adding: “We now want to see much larger, nationwide studies to understand if MRI is being used as the first step in the investigation .” could form the basis for a national screening program.”
Professor Mark Emberton, consultant urologist at UCLH and senior author of the study, added: “The death rate from prostate cancer in the UK is twice that of countries like the US or Spain because our level of testing is much lower than in other countries. “
“Given the treatability of prostate cancer if caught early, I am confident that a national screening program will significantly reduce the prostate cancer mortality rate in the UK.” I believe this will be possible within the next five to ten years .”
“I had no symptoms. Without the MRI scan, I never would have known I had prostate cancer.
Martin Rainsford, who had a family history of prostate cancer but had no symptoms himself, decided to take up the offer and participate in a trial of a new 10-minute MRI scan to see if it could diagnose the disease better than the standard Prostate Specific Antigen (PSA). ) blood test.
“I had had a PSA test the year before, which was normal, but since my father had prostate cancer — although he didn’t die from it — it was too good an opportunity to pass up,” says Martin, 67, a former headmaster living in London with his wife Katharine.
As part of the trial, he underwent a PSA test in April 2020, which came back to normal – his PSA score was 1.8 (below the level that needs further investigation).
Martin Rainsford (pictured) had a family history of prostate cancer but had no symptoms himself and decided to accept the offer to take part in a trial of a new 10-minute MRI scan
However, the results of the MRI scan performed at the same time revealed a very different story: they suggested that Martin did in fact have prostate cancer.
Further tests – a more detailed MRI and a biopsy – confirmed not only that he had prostate cancer, but that it was severe enough to require treatment.
‘I was surprised. I know prostate cancer is very common in men my age, but I had no symptoms. Without the MRI, I would never have known I had prostate cancer,” says Martin, who now runs an education charity.
After being diagnosed, Martin underwent “focal” therapy at NHS University College Hospital in London in August 2020.
Instead of surgically removing the entire prostate or undergoing radiation therapy, which carries side effects such as impotence, high-intensity focused ultrasound (HIFU) has been used to heat and destroy cancer cells.
Martin is now cancer free. “Because the prostate cancer was caught early, it was easier to treat and I had more treatment options.” I don’t want to think about how far my cancer would have progressed before it was detected if I had relied on the PSA test alone . “Early detection of prostate cancer should be available to all men so that every man has the opportunity to catch the disease early and before it’s too late,” says Martin.