Prostate screening should be rolled out for men with a dangerous gene mutation similar to the one carried by Hollywood actress Angelina Jolie, major study suggests
- Men with the BRCA-2 genetic fault have nearly double the risk of the disease
- The gene mutation is similar to the BRCA-1 gene fault carried by Angelina Jolie
- There is no NHS routine screening programme for anyone with prostate cancer
Sir Rod Stewart has urged men to get checked for prostate cancer after revealing he underwent treatment for the disease
Prostate screening should be introduced for men with a dangerous gene mutation, a major study suggests.
Experts at the Institute of Cancer Research in London found men with the BRCA-2 genetic fault have nearly double the risk of developing prostate cancer.
The researchers called for a ‘systematic’ screening programme of annual blood tests for men who carry the mutation – which is similar to the BRCA-1 gene fault carried by Angelina Jolie.
At the moment there is no NHS routine screening programme for anyone with prostate cancer.
The only test currently available – the ‘prostate specific antigen’ or PSA test – is considered to be too unreliable for a formal screening programme, so is only offered to men over the age of 50 if they request it.
But the researchers said for men with the BRCA-2 mutation the benefits of early diagnosis outweigh the shortfalls of the test.
Study leader Professor Rosalind Eeles said her team will today submit their findings to the European Association of Urology, which sets professional guidelines for prostate cancer, in a bid to make screening routine for men with the mutation.
One in every 300 men carry the BRCA-2 mutation.
The researchers, whose findings are published in the European Urology journal, tracked 1,400 men for three years.
TV legend Stephen Fry posted a heartfelt video online last February which revealed that he had been battling prostate cancer
The Daily Mail is campaigning for an urgent improvement of prostate cancer treatments and diagnosis, which lags years behind other diseases such as breast cancer
They found those with the faulty gene were 95 per cent more likely to develop prostate cancer – a near doubling of risk – than those without.
And 77 per cent of carriers who developed prostate cancer had an aggressive form of the disease – compared with 40 per cent of non-carriers.
SIR ROD URGES MEN TO GET CHECKED FOR PROSTATE CANCER
Sir Rod Stewart has urged men to get checked for prostate cancer after revealing he underwent treatment for the disease.
The singer, 74, secretly fought the cancer for three years after being diagnosed during a routine check-up.
He has now been given the all-clear and urged men to ‘go to the doctor’, admitting he tried to ‘keep a smile on his face’ throughout the ordeal.
‘Two years ago I was diagnosed with prostate cancer,’ he revealed to an audience in London during a fundraising event.
‘No one knows this, but I thought this was about time I told everybody. I’m in the clear, now, simply because I caught it early. I have so many tests.’
Prostate cancer is the most common cancer in men, affecting around one in eight during their lifetime.
They were developed the disease at a younger age – 61 compared to 64 – which raises the chance of a more serious form of cancer.
Crucially, 80 per cent of those in the trial whose disease were spotted using annual PSA tests were diagnosed before it had spread around the body – meaning they could be effectively treated.
The Daily Mail is campaigning for an urgent improvement of prostate cancer treatments and diagnosis, which lags years behind other diseases such as breast cancer.
For breast cancer, for example, women have regular mammograms if they carry a BRCA mutation.
Professor Eeles said: ‘For women who undergo genetic testing, options are available to them if they carry a BRCA fault, including preventative surgery and increased screening.
‘But there’s no prevention pathway in place if men decide to find out if they’re a carrier, which is why our research is so important.’ She said BRCA faults are often passed from parent to child – including from mother to son – so men with a family history of breast or ovarian cancer should receive a DNA test to see if they carry the genetic mutation.
A family history of prostate cancer itself is not such a strong indicator that someone carries the gene, but if a father, grandfather or uncle has been diagnosed with the disease before the age of 65 it is worth having a DNA test to see whether they carry the BRCA-2 mutation.
Professor Eeles added: ‘Based on our results, we would recommend offering men who carry a fault in the BRCA-2 regular PSA tests, so that they can be diagnosed and treated earlier.’ The research team, which is funded by Cancer Research UK, is continuing the trial to see whether the same applies to the BRCA-1 genetic mutation, carried by one in 500 men.
Miss Jolie, 44, famously chose to have her breasts, ovaries and fallopian tubes removed to reduce her cancer risk, after her mother died of ovarian cancer aged just 56.
Referrals for genetic testing doubled in Britain in the two months after Miss Jolie announced she had undergone the first of her procedures in 2013.
Sarah Coghlan, of the Movember men’s health charity, said: ‘Studies like this demonstrate just how complex a disease prostate cancer is.
‘It’s very important for clinicians to understand what’s driving a man’s risk of disease so that they can choose the best preventative action and appropriate treatment.
‘A lot of the discussion around genetic testing for mutations such as BRCA-2 has centred around women and breast cancer.
‘The assumption has been that it’s not relevant to men.
‘Men need to be aware that having a family history of breast or ovarian cancer, could mean they are at greater risk of developing prostate cancer. They need to be asking questions about their own family history and share their own more comprehensively with immediate family members.’
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 last 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
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