Issue 1802 Science

Cheap and fast prostate cancer test developed

Saachi Sachdev explores how researchers at Imperial College London are working to improve prostate cancer testing

Saachi Sachdev

31 May 2022 — 3 min read

Prostate cancer is a type of cancer that grows in the tissues of the prostate glands in men. These glands, although just the size of a walnut, are the source of the most diagnosed cancer in the UK. Every year almost 47,500 men suffer with prostate cancer and this figure is progressively rising, with almost 1 in 6 men being currently diagnosed in the UK.

Those at a higher risk of prostate cancerMen over 50 years of ageThose with African ancestryThose with a family history of prostate cancer

As with all types of cancer, early identification and treatment is key to improve prognosis. However, the slow growth and nature of prostate cancer means that alarming symptoms, such as blood appearing in urine and interrupted urine flow, do not begin until the tumour has already developed.

A new prostate cancer test: Multi-Parametric Ultrasound (mpUSS)

Researchers at Imperial College London, University College London and Imperial College Healthcare NHS Trust have recently developed a new type of scan that could potentially help with the early detection of prostate cancer. The technique, called Multi-Parametric Ultrasound (mpUSS) utilises soundwaves to take images of the prostate. The method was tested in the new trial, Cancer Diagnosis by Multi-Parametric Ultrasound of the Prostate, or CADMUS.

Explainer - The current prostate cancer test: Multi-Parametric MRI (mpMRI)Prostate cancer is typically diagnosed with the Multi-Parametric Magnetic resonance imaging (mpMRI) technology. This type of scan can detect cancer in the prostate gland by effectively combining 4 separate images together, producing a more detailed image compared to a standard MRI scan.The mpMRI method, although over 93% effective, can be expensive and time consuming, which greatly limits the number of scans a doctor is able to carry out. Moreover, patients who have undergone procedures involving the insertion of metallic components (such as pacemakers) are excluded from mpMRI due to its utilisation of a magnetic field, which can damage metallic devices. As prostate cancer risk increases with age, this limitation poses a problem for the older population of men, who comprise a large proportion of patients who have undergone excluding procedures. In order to screen as many of the at-risk population as possible, a different faster and more cost-effective scanning method is required to ensure early diagnosis is achieved.

The CADMUS trial included 370 male patients who were identified as having a high risk of prostate cancer by a round of initial tests. The men were then required to undergo both a mpMRI and the new mpUSS scan – a total of 257 men were identified as having a positive mpUSS or mpMRI result. Further diagnosis of prostate cancer was confirmed for these patients through a biopsy, and abnormal tissue was subsequently detected in 133 men: mpUSS had detected 66 cases and mpMRI detected 77 cases. Although mpUSS detected 4.3% fewer prostate cancer cases compared mpMRI, the test resulted in 11.1% more patients having a biopsy – this was due to the mpUSS scan occasionally detecting abnormal areas where there is no cancerous tissue. However, this can be advantageous for patients as it encourages conducting more biopsies and being tested thoroughly, rather than potentially failing to detect a cancerous tissue.

What does this mean for the future of prostate cancer?

As the mpUSS scan is more affordable and is faster to conduct than the current mpMRI, this can greatly reduce the economic impact of testing on the NHS. Additionally, it will allow for more men to undergo the test, which could potentially lead to a reduced number of severe prostate cancer cases. The mpUSS is also favourable for patients with metal hip replacements, pacemakers, or claustrophobia, whilst still maintaining an effective prostate cancer diagnosis. Worldwide, this technology provides an alternative, cheaper method of diagnosis, and could therefore be invaluable for men in developing countries, where cases are already common and rapidly increasing. The mpUSS scan is expected to help reduce prostate cancer development through early detection, and could even be used alongside current methods.

The CADMUS trial was funded by The Jon Moulton Charity Trust and Prostate Cancer UK.