Focus on: Prostate Cancer
The impact of Covid-19 doesn’t stop here. There is a looming cancer crisis with prostate cancer urgent GP referrals falling by 52,000 in 2020, due to Covid-19 (Source – Prostate Cancer UK).
What is Prostate Cancer?
Those born male or intersex will have a prostate. It is a gland, usually the size and shape of a walnut – this grows bigger as you age. It sits underneath the bladder and around the urethra. The role of the prostate is to make semen – the fluid that sperm is carried in. Sometimes cells in the prostate start to grow in an uncontrolled way and if this happened prostate cancer can develop. Some prostate cancers can grow quickly, and they need fast treatment to stop it spreading.
Prostate Cancer in the UK
In the UK, 1 in 8 men will get prostate cancer in their lifetime
Around 48,500 men are diagnosed with prostate cancer in the UK each year
Prostate cancer is the second most common cause of cancer death in UK males
There are around 11,500 prostate cancer deaths in the UK every year, that's 31 every day (2014-2016)
There is a higher risk of prostate cancer in men over 50, black men, and those with a family history
The UK has some of the worst prostate cancer survival statistics of any European country.
How CCL can help with Prostate Cancer
CCL looks to adopt new technologies for diagnostics and treatment pathways to help UK healthcare. Never more needed than after the Covid-19 pandemic. We have a range of tests available to help diagnose or manage prostate cancer.
Initial screening test:
PSA
Prostate-Specific Antigen (PSA) is a protein produced by ‘normal’, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a man's blood. For this test, a blood sample is sent to CCL’s laboratory for analysis.
Diagnosis:
Select MDx
SelectMDx helps physicians determine if a patient is at high or low risk for prostate cancer and which men can safely avoid biopsy. A non-invasive urine test - SelectMDx measures the expression of two mRNA cancer-related biomarkers (HOXC6 and DLX1). The test provides binary results that, when combined with the patient’s clinical risk factors, help the physician determine whether:
The patient may benefit from a biopsy and early prostate detection, or
The patient can avoid an unnecessary biopsy and return to routine screening.
Proclarix®
Proclarix is an easy to use simple protein-based blood test that can be done with the same sample as the PSA test. No additional intervention is required with results becoming quickly available. Patients with a PSA level between 2 and 10 ng/ml are in a diagnostic grey zone. In these cases, the doctor faces an inconclusive situation without having sufficient information to decide whether to continue investigating or discharge the patient. Unclear results cause patients anxiety and require both additional time spent on health care procedures and unnecessary biopsies. Proclarix helps doctors and patients with PSA levels in the grey zone. Its Proclarix Risk Score delivers clear and immediate diagnostic support for further treatment decisions. Proclarix gives clear results on the risk of prostate cancer. No action versus immediate action.
After diagnosis:
Prostatype®
The Prostatype® Test System combines gene expression information with currently used clinical parameters (PSA, Gleason Score, and Tumor Stage) and calculates the so called P-score. The test is based on a unique database containing prostate cancer patients and provides decision support for patients and doctors when making a treatment decision. Prostatype Genomics has identified three stem cell genes, IGFBP3, F3 and VGLL3 that are correlated with both overall and prostate cancer-specific survival. The test is performed on the already existing biopsies obtained at diagnosis, hence there is no need for new painful and potentially harmful sampling of the prostate. Prostatype®'s unique system identifies the genetic fingerprint of cancer by measuring information from these cancer stem cell genes. More specifically, Prostatype® quantifies RNA expression levels of these three stem cell genes in the individual patient’s tumor and thereby provides unique tumor biology that existing clinical pathological factors cannot. The gene expressions together with other clinical parameters such as PSA, Gleason and Tumor stage are entered into the Classification of Prostatic Malignancy Algorithm (CPMA) software that is linked to a unique patient data base. The software calculates the so called P-score that provides a measure of how aggressive the cancer is, which facilitates the choice of optimal treatment for the patient.
Somatic and germline testing
All men with metastatic prostate cancer should consider testing for germline mutations, as should men with a family history of cancer suggesting hereditary cancer predisposition, an international consensus panel recommended. The experts supported use of a large gene panel for germline testing, with priority given to BRCA1/2 and DNA mismatch-repair (MMR) genes. Testing for additional genes should be guided by personal or family history. From 12%-17% of men with metastatic prostate cancer harbour germline mutations, primarily in DNA repair genes (BRCA1/2, CHEK2, ATM, PALB2, and DNA MMR genes), as do about 7% of men with localized prostate cancer. Increasingly, determination of a patient's mutation status has the potential to inform decision making about treatment options, referral to clinical trials, and active surveillance for men with localized disease. (Medpage today). At CCL we offer a range of Next Generation Sequencing panels to aid clinicians with regards to treatment and family history.
How to access our tests
If you are a Health Care Professional, please contact us on +44 (0)1223 395 450 / info@camclinlabs.co.uk. If you are a patient, please refer your Health Care Professional to our website and ask them to get in touch. Please note that Cambridge Clinical Laboratories HCP services are only available through a professional healthcare provider.
Useful resources
(Source - Prostate Cancer UK & Cancer Research UK)