Test tells if prostate cancer is likely to spread

Men diagnosed with prostate cancer could soon be told through a genetic test whether they are among the one in three patients who are at risk of getting an advanced form of the disease.

Scientists have discovered the genetic fingerprint that switches curable, localised prostate cancer into the aggressive form which spreads to lymph nodes or tissue in other parts of the body.

Only 30 out of every 100 men will survive their cancer for five years or more after they are diagnosed with advanced cancer at stage 4, but all men diagnosed with stage 1 cancer, where it is contained within the prostate gland, will survive for five or more years.

The discovery by Robert Bristow at the Princess Margaret Cancer Centre in Toronto and Dr Paul Boutros from the Ontario Institute for Cancer Research could lead to personalised therapies from the moment of diagnosis.

Prostate cancer is the most common form of the disease in men in the UK, with around 47,000 new cases diagnosed every year. It kills over 11,000 people, making it the second biggest cancer killer.

Professor Bristow and his team used DNA sequencing techniques to focus on the genetics of prostate cancers so that they could understand what makes one man’s disease different to another’s. ‘‘These genetic fingerprints had high accuracy in being able to discern those men who do well with surgery or radiotherapy and those men that already have early spread of their disease outside the prostate gland,’’ he said.

‘‘This information gives us new precision about the treatment response of men with prostate cancer, and important clues as to how to better treat one set of men versus the other to improve cure rates overall.’’

The study, published in Nature, analysed the tumours of 500 Canadian men in the general population with localised, noninherited prostate cancer.

The next step will be to translate this research finding into a molecular diagnostic tool that can be used in clinics.

In a related study published in Nature Communications the same team discovered the genetic code of the BRCA-2 inherited disease, which becomes lethal in rare cases and affects the repair of DNA damage in cells.