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Scientists say a new genetic test could predict aggressive prostate cancer, but it will be a few years before doctors may be offering this option. If the new screening test does become a reality, the ability to predict aggressive prostate cancer would be a major step in the fight against this disease.
The groundwork for such a test was laid by a team of scientists at the Institute of Cancer Research in London, where they showed there are 13 mutations in eight DNA repair genes that prevent the genes from making a protein that functions properly. Men who have any of these 13 mutations were found to be at much greater risk of developing aggressive prostate cancer. This information could be used to create a test to predict aggressive prostate cancer risk.
Currently physicians are not able to accurately identify which men with prostate cancer will go on to develop an aggressive form of the disease, and that uncertainty in turn makes it difficult for men and their doctors to decide how aggressive treatment should be. Generally, the more intense the treatment the more likely men are to experience serious, life-altering side effects such as urinary incontinence, erectile dysfunction, and male infertility.
Having the ability to identify which men are most likely to benefit from an intensive treatment approach would allow men not at high risk of aggressive disease to pursue a more moderate treatment approach and thus avoid or reduce the side effects that impact quality of life.
How the study worked
The scientists collected blood samples from 191 men who had prostate cancer and at least three close family members who also had a history of the disease. After evaluating all the samples for the mutations, the investigators found that 7 percent of the men had one of the high-risk indicators. These same men also had an aggressive form of prostate cancer.
According to Dr. Zsofia Kote-Jarai, one of these study’s authors and senior staff scientist at The Institute of Cancer Research, “I can see in two to three years offering screening to men with prostate cancer and to men worried about their family history.” Study co-leader Professor Ros Eeles, professor of oncogenics at the same institute, pointed out that even though the study was small, “we proved that testing for known cancer mutations can pick out men who are destined to have a more aggressive form of prostate cancer.”
In the meantime, a large trial that involves 2,000 men and testing of 192 genes is currently underway. The hope is that these and future studies will show that a genetic test can be used to predict aggressive prostate cancer and thus change how men with the disease are treated.
Leongamornlert D et al. Frequent germline deleterious mutations in DNA repair genes in familial prostate cancer cases are associated with advanced disease. British Journal of Cancer 2014; 10: 1663-72
ScienceDaily 2014 Feb. 14