01.03.2024

Prostate cancer breakthrough as ‘exciting’ study finds 10-minute MRI scans can pick up TWICE as many serious cases as existing tests

A simple ten-minute scan picks up twice as many serious prostate cancer cases as the existing test, research published today suggests. Using a quick MRI scan produces far better results in identifying cases than the prostate-specific antigen, or PSA, blood test, according to the study.

Under current guidelines, men with a PSA reading of below 3 nanograms per millilitre would be considered low risk for prostate cancer and not referred for further investigations.

But more than half of the men in the trial whose MRI scan identified an abnormality and were then diagnosed with prostate cancer serious enough to need treatment had a PSA below 3.

The study was also the first to measure PSA ‘density’ – a figure based on the PSA level from a blood test compared with the volume of the prostate gland.

Terry Noonan, 64, took part in the trial and found out he had an aggressive cancer. He had his prostate removed within weeks and is now cancer free

Terry Noonan, 64, took part in the trial and found out he had an aggressive cancer. He had his prostate removed within weeks and is now cancer free

‘I was so lucky to be in the trial’

Retired accountant Terry Noonan was 61 when his GP suggested he join a trial to see whether a ten-minute MRI scan was better at diagnosing prostate cancer than the standard PSA blood test.

Mr Noonan’s scan at University College London Hospital in November 2020 revealed he was at risk. His PSA density – a new measure for screening which combines a man’s PSA level with the volume of the prostate gland, measured by the MRI scan – was also raised.

Further tests confirmed he had an aggressive cancer. He had his prostate removed within weeks and is now cancer free. Mr Noonan, 64, said: ‘I feel very lucky – the treatment was a complete success.’

Experts think this is more accurate because PSA levels and the size of the prostate increase with age.

The standard PSA test can lead to older men being wrongly told they are at risk because their PSA is raised.

Scientists involved in the study, called REIMAGINE, believe the ten-minute MRI, combined with PSA density, could revolutionise prostate cancer diagnosis and possibly lead to a national screening programme for the disease.

Caroline Moore, a professor of urology at University College London and consultant at University College London Hospital who led the research, said: ‘The thought that over half of the men with clinically significant cancer had a PSA less than 3ng/ml – and would have been reassured that they didn’t have cancer – is a sobering one and reiterates the need to consider a new approach to screening.

‘Our results give an early indication that MRI could offer a more reliable method of detecting potentially serious cancers early.’

Each year, 52,000 men in the UK are diagnosed with the cancer, and more than 12,000 die of it.

The standard PSA test remains the most common way of seeing who needs further testing, despite it being unreliable.

This leads to some having unnecessary tests, and those with cancer being diagnosed late.

In the new study, 303 men aged 50 to 75 had a ten-minute MRI scan of the prostate as well as a PSA density test.

(Stock Photo) Using a quick MRI scan produces far better results in identifying cases than the prostate-specific antigen, or PSA, blood test, according to the study

(Stock Photo) Using a quick MRI scan produces far better results in identifying cases than the prostate-specific antigen, or PSA, blood test, according to the study

The MRI suggested 16 per cent – 48 men – were at risk of cancer, yet two thirds of these men had a PSA under 3.

More detailed scans showed 25 of these men had cancer serious enough to need treatment, 15 of whom would not have been picked up by a standard PSA test.

Separately, the PSA density test identified a further 16 men at risk of prostate cancer of whom four were found to have disease that needed treatment.

Simon Grieveson, assistant director of research at the charity Prostate Cancer UK, said the results were ‘extremely exciting’, adding: ‘We now want to see much larger, UK-wide studies to understand if using MRI as the first step in getting tested could form the basis of a national screening programme.’

Professor Mark Emberton, a consultant urologist at UCLH and senior author of the study, added: ‘The UK prostate cancer mortality rate is twice as high as in countries like the U.S. or Spain because our levels of testing are much lower than other countries.

‘Given how treatable prostate cancer is when caught early, I’m confident that a national screening programme will reduce the UK’s prostate cancer mortality rate significantly. I believe this will be possible within the next five to ten years.’

‘I had no symptoms. Without the MRI scan I would never have known I had prostate cancer’

With a family history of prostate cancer but no symptoms himself, Martin Rainsford decided to take up the offer to join a trial of a new 10-minute MRI scan to see if it was better at diagnosing the disease than the standard prostate specific antigen (PSA) blood test.

‘I’d had a PSA test the year before which was normal but as my dad had prostate cancer — although he died with it not because of it — so it was too good an opportunity to miss,’ says Martin, 67, a former headteacher who lives in London with his wife Katharine.

As part of the trial, in April 2020 he had a PSA test, which again came back normal – his PSA was 1.8 (below the level which requires further investigation).

With a family history of prostate cancer but no symptoms himself, Martin Rainsford decided to take up the offer to join a trial of a new 10-minute MRI scan

But the results of the MRI scan, carried out at the same time, revealed a very different story: suggesting Martin did have prostate cancer.

Further tests — a more detailed MRI and biopsy — confirmed not only did he have prostate cancer but that it was serious enough that it needed treating.

‘I was surprised. I know prostate cancer is very common in men of my age but I had no symptoms. Without the MRI scan I would never have known I had prostate cancer,’ says Martin, who now runs an education charity.

Following the diagnosis Martin underwent ‘focal’ therapy in August 2020 on the NHS at University College Hospital, London.

Instead of surgically removing the entire prostate or undergoing radiotherapy, which carry side-effects such as impotence, high-intensity focused ultrasound (HIFU) was used to heat and destroy cancer cells.

Martin is now cancer free. ‘Because the prostate cancer was caught in the early stages, it was easier to treat and I had more treatment options. I hate to think how far my cancer might have advanced before it was spotted if I’d relied on the PSA test alone. Prostate cancer screening should be available to all men so that every man gets the opportunity to have the disease caught early and before it’s too late,’ says Martin.

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