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Prostate cancer grading lacks accuracy

Friday April 11th, 2014

Tests to identify the severity of prostate cancer have proved wildly inaccurate, researchers warn today.

As many as 50% of men whose cancers are shown to be slow-growing by current procedures proved later to have much more aggressive disease.

And about two thirds of these were found to have cancer spreading throughout the body - although tests beforehand suggested the disease was "slow-growing."

The findings, reported in the British Journal of Cancer, highlight the problems doctors face in deciding what treatment to recommend to patients.

The researchers at Cambridge University analysed the fate of more than 800 men. They compared the stage and grade allocated to the cancer before treatment with findings after surgery.

Some 415 men were classified as having slow-growing cancer - but 209 of these were later found to have aggressive cancer. And 131 men had disease that had spread beyond the original organ.

Researcher Greg Shaw said: “This highlights the urgent need for better tests to define how aggressive a prostate cancer is from the outset, building on diagnostic tests like MRI scans, and new biopsy techniques which help to more accurately define the extent of the prostate cancer.

"This would then enable us to counsel patients with more certainty whether the prostate cancer identified is suitable for active surveillance or not.”

Professor Malcolm Mason, of Cancer Research UK, said: "We need better methods of assigning a grade and stage so that no man has to unnecessarily undergo treatment, while at the same time making sure we detect and treat the cancers that really need it."

He added: "Despite the limitations that this study shows, all evidence so far points to active surveillance being safe provided men are carefully selected."

Identification of pathologically insignificant prostate cancer is not accurate in unscreened men British Journal of Cancer 11 April 2014

Tags: Cancer | Menís Health | UK News

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