Thousands of prostate cancer patients could be spared gruelling treatment after a breakthrough by British scientists.
Experts at Cambridge University have created a tool that calculates a man’s chances of dying from the cancer with 90 per cent accuracy.
Their model also works out how much each patient will benefit from surgery, radiotherapy or other radical treatment – or whether it is worth simply monitoring them.
For about a third of prostate patients – roughly 15,000 of all those diagnosed in Britain every year – the chance of dying is so low that the advantages of treatment are minimal.
Thousands of prostate cancer patients could be spared gruelling treatment after a breakthrough by British scientists
The Cambridge team created their model after tracking 10,000 British patients for a decade. They then tested it on 2,500 men in Singapore and found it to be 90 per cent accurate.
The current NHS model simply divides men into three groups depending on how severe their cancer is, and is accurate just 60 per cent of the time.
Study leader Vincent Gnanapragasam, a consultant urologist at the University of Cambridge, said: ‘When men are diagnosed with prostate cancer and are deciding what to do they are often given wishy-washy advice which hugely depends on who they have spoken to. Our work puts a number on it to help guide those decisions.’
The Daily Mail is campaigning for urgent improvement in prostate cancer treatments, which are thought to be 20 years behind treatments for breast cancer. Part of the problem is that while breast cancer treatments are increasingly tailored to the patient, prostate treatments still rely on a ‘one-size-fits-all’ approach.
The new findings promise to begin closing that gap. The researchers, who will present their findings at the European Association of Urology conference in Copenhagen next week, found that the fifth of men with the most aggressive cancers were 20 times more likely to die of prostate cancer within ten years than those with the least aggressive.
The prediction model – which will be put on the internet for patients and their doctors to use later this year – takes a man’s age, medical history, blood test and biopsy results and gives a personalised chance of surviving ten years.
Experts at Cambridge University have created a tool that calculates a man’s chances of dying from the cancer with 90 per cent accuracy
Men with aggressive cancer see their survival chances increase significantly if they receive treatment – but those with localised, slow-growing cancers barely see any difference, because they are more likely to die of other causes instead. A man of 72 with low-grade prostate cancer, for example, might have a 6 per cent chance of dying of prostate cancer within a decade – but a 24 per cent chance of dying of something else entirely, giving him an overall mortality risk of 30 per cent.
Radical treatment such as radiotherapy or prostate removal would cut his prostate-mortality to just 3 per cent – but his overall chance of death would remain barely reduced at 27 per cent. This means he would undergo gruelling treatment for barely any benefit, and yet risk side effects such as impotence and incontinence.
A 71-year-old man with more aggressive cancer, however, would see his prostate cancer death chance drop from 26 per cent to 13 per cent with treatment, cutting his overall mortality from 46 per cent to 34 per cent, so would likely want treatment.
We are not telling men, you have no risk, you do not need treatment. We are telling them, these are the facts.
Mr Gnanapragasam said: ‘We are not telling men, you have no risk, you do not need treatment. We are telling them, these are the facts.
‘We are trying to reduce rates of overtreatment. I would say 30 per cent or more of men diagnosed with prostate cancer may not benefit from treatment, based on our models.
‘When men see their absolute risk of dying is quite low, they find it easier to decide to just monitor their cancer rather than choosing treatment.’
Dr Iain Frame of Prostate Cancer UK said: ‘Too many men undergo radical treatments for prostate cancer, and in some cases endure life-changing side effects, for a cancer that may never cause them harm. A tool like this has tremendous potential.’
WHAT IS PROSTATE CANCER?
How many people does it kill?
Prostate cancer became a bigger killer than breast cancer for the first time, official statistics revealed earlier this year.
More than 11,800 men a year – or one every 45 minutes – are now killed by the disease in Britain, compared with about 11,400 women dying of breast cancer.
It means prostate cancer is behind only lung and bowel in terms of how many people it kills in Britain. In the US, the disease kills 26,000 each year.
Despite this, it receives less than half the research funding of breast cancer – while treatments for the disease are trailing at least a decade behind.
How quickly does it develop?
Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS.
If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted.
Some patients can be cured if the disease is treated in the early stages.
But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.
Thousands of men are put off seeking a diagnosis because of the known side effects from treatment, including erectile dysfunction.
Tests and treatment
Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge.
There is no national prostate screening programme as for years the tests have been too inaccurate.
Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.
Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.
But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof.
Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks.
Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org