Prostate cancer medical imaging

Liquid biopsy could help catch aggressive prostate cancers earlier

Fast and accurate diagnosis of cancer is essential to give patients the best chance of beating the disease and new research from Queen Mary University of London could give further hope in the fight against prostate cancer.

The new liquid biopsy test trialled in the UK is a blood test to detect circulating tumour cells (CTCs) which have split from the original tumour to be found in the bloodstream. Researchers hope this test will indicate if a prostate tumour is likely to spread to other parts of the body (metastasise).

There are several pathology tests currently used to diagnose and monitor prostate cancer. A blood test that looks for Prostate Specific Antigen (PSA) is commonly used as a screening tool, and the results of this test may be the first red flag in the diagnostic chain.

Researchers found that when the CTC tests were combined with the PSA test, they could predict the presence of aggressive prostate cancer in subsequent biopsies with more than 90 per cent accuracy, better than any previously reported biomarkers.

Lead researcher Professor Yong-Jie Lu from Queen Mary University of London said: “Testing for circulating tumour cells is efficient, non-invasive and potentially accurate, and we’ve now demonstrated its potential to improve the current standard of care. By combining the new CTC analysis with the current PSA test, we were able to detect prostate cancer with the highest level of accuracy ever seen in any biomarker test.”

The number and type of CTCs present in the blood could also indicate how aggressive the cancer was, which can help doctors to determine what course of action is best for a patient.

As PSA levels can be raised for reasons other than cancer, PSA test results are used as a screening tool to identify men who may need more regular monitoring or further tests.

Chemical Pathologist, Associate Professor Ken Sikaris said Australia’s current screening practices work well, but new research in the area is welcome:

“It’s encouraging that research is progressing in this area, this study certainly shows potential but more studies are needed. We must be cautious when seeking to apply UK research to the Australian context as pathology practices and guidelines differ between countries. We want to encourage those eligible to discuss the PSA test with their doctor, and not to be fearful. It’s important to note that an abnormal PSA result does not automatically lead straight to another procedure such as a biopsy.”

Pathologists, other specialist doctors and patient organisations have worked together to develop the latest guidelines on PSA testing to maximise the benefits and minimise risk for patients.

High quality standards make Australia’s pathology services among the best in the world, but participation is key. Our fantastic pathology system and the tests we have available can only help Australians who take part in testing.

The guidelines recommend PSA testing every 2 years for men over 50, or if you have a family history of prostate cancer you may start testing from age 40.

Steve Callister, Chairman of the Prostate Cancer Foundation of Australia told Channel 9: “Obviously more needs to be done. 3,500 men are dying and we need to make more men aware of catching it early.”