Tag Archives: cancer studies

Prostate cancer test improved

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A new approach may help to improve the accuracy of tests for the number one cancer in men.

Prostate cancer holds an unenviable title: it is the most common cancer in men in the UK comprising just under one quarter of all newly diagnosed cancer cases in men. In 2008 around 101 men were diagnosed with cancer in the UK every day but the heartening news is that only one in 26 men die of prostate cancer; they are more likely to die with it than from it.

One difficulty that doctors and their patients face is that diagnosing this particular cancer is not an exact science. A Prostate Specific Antigen (PSA) test, to look for raised PSA levels in your blood is the most commonly used but a raised level doesn’t necessarily mean you have cancer. The majority of men who do have the disease don’t have raised PSA levels and over 65 percent of men with a raised level don’t have cancer.

There are other tests, including a digital rectal examination (DRE), where your doctor feels for changes in the surface of your prostate gland by putting a finger up your bottom. If your GP thinks you are at risk of having prostate cancer they will refer you to a hospital for further tests. The test you are most likely to have is the transrectal ultrasound-guided biopsy (TRUS). Using an ultrasound probe your doctor will take tissue samples from your prostate.

The prostate

The prostate

A recent study from the University of Michigan Comprehensive Cancer Center and the Michigan Center for Translational Pathology may provide cancer specialists with another, more reliable means of diagnosing prostate cancer. The new test looks for gene fusion – TMPRSS2:ERG – to give the scientific name. This fusion is believed to cause prostate cancer – studies of prostate tissue have shown its presence nearly always indicates cancer.

Because TMPRSS2:ERG only occurs in about 50 percent of prostate cancers, the scientists added PCA3, another marker, to their test. These combined elements were better at predicting cancer than either used on its own.


“Testing for TMPRSS2:ERG and PCA3 significantly improves the ability to predict whether a man has prostate cancer,” says lead author Scott Tomlins, MD, PhD, a pathology resident at the University of Michigan. “We think this is going to be a tool to help men with elevated PSA decide if they need a biopsy or if they can delay having a biopsy.”

“Many more men have elevated PSA than actually have cancer but it can be difficult to determine this without biopsy. This test will help in this regard. The hope is that this test could be an intermediate step before getting a biopsy,” explained senior study author Arul Chinnaiyan, MD, PhD, director of the Michigan Center for Translational Pathology.

The test isn’t available yet, but the University of Michigan hope to be able to offer it to their patients within the year.

Paracetamol linked to blood cancers

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Regular users of paracetamol have an increased risk of developing blood cancers, researchers have found.

The tablets contain a chemical called acetaminophen which has been linked to cases of cancer in a number of individuals who were taking the drug.

The findings will terrify the millions in America and worldwide who pop the pills to cure minor ailments without so much as a second thought.

Earlier work has shown that aspirin use might lower the odds of dying from colon cancer but increase the risk of bleeding ulcers. The picture has been less clear for blood, or haematologic, cancers, however.

The finding adds another twist to the complicated evidence linking cancer and painkillers, and hints acetaminophen might be different from the rest.

‘Prior to this study there was very little evidence that aspirin reduces your risk of haematological cancers,’ said Emily White of the Fred Hutchinson Cancer Research Center in Seattle, who worked on the new research.

Paracetamol

Paracetamol

There were some suggestions that acetaminophen might increase the risk of the cancers, on the other hand, but those were based on individual cases of blood cancer.

Studies of individual patients aren’t considered as strong as the new one, which tracked a large population of healthy people over time.

‘We have the first prospective study,’ White said.

Still, she warned, there is no proof that acetaminophen causes cancer, and the new results need to be confirmed before they are used in any treatment decision.

Earlier work has linked acetaminophen to asthma and eczema as well, but scientists still don’t agree on whether the drug is the actual culprit or just an innocent bystander.

The new study suffers from the same limitations, in that people who use lots of painkillers could be dealing with medical problems that set them up for cancer down the road.

The scientists followed nearly 65,000 older men and women in Washington State. At the outset, they asked the participants about their use of painkillers over the past ten years and made sure that no one had cancer (except skin cancer).

Over some six years on average, 577 people — or less than one percent — developed a cancer involving the blood cells. Examples of such cancers include lymphoma and myelodysplastic syndrome, or MDS.


More than nine per cent of people who developed one of these cancers used high amounts of acetaminophen, compared to only five percent of those who didn’t get sick.

After accounting for things like age, arthritis and a family history of certain blood cancers, chronic acetaminophen users had nearly twice the risk of developing the disease.

‘A person who is age 50 or older has about a one-percent risk in ten years of getting one of these cancers,” White said. “Our study suggests that if you use acetaminophen at least four times a week for at least four years, that would increase the risk to about two percent.’

No other painkillers — including aspirin and ibuprofen — were tied to the risk of blood cancers.

Dr. Raymond DuBois, a cancer prevention expert at the University of Texas MD Anderson Cancer Center in Houston, said acetaminophen works very differently than other painkillers and so might be expected to have different effects on cancer.

‘It was quite surprising to see that acetaminophen use increased the risk of blood cancers,’ said DuBois, who was not involved in the study.

McNeil Consumer Healthcare, the Johnson & Johnson subsidiary that sells Tylenol, did not respond to requests for comment.

White said it is too soon to make any recommendations based on the new study, and that none of the painkillers is free of side effects.

‘Long-term use of any over-the-counter drug might have adverse effects,” she said. ‘You have to weigh the benefits against the risk of all the drugs.’