15 minute lifeguard for men: It’s called a ‘Prostagram’

University lecturer Mark Jenkins first heard about the clinical trial that saved his life from a tweet.

Actor Stephen Fry, who had prostate cancer in 2017, highlighted ‘an important attempt at prostate cancer’ and added: ‘Consider inviting yourself to this’, which led to Mark signing up.

It was thanks to the trial at Imperial College London, which investigated a new, quick way to detect the disease, that Mark was found to have an aggressive tumor, even though he had no symptoms.

“Without that study, I would not be here now,” he says two years after undergoing surgery that may have saved his life.

University lecturer Mark Jenkins first heard about the clinical trial that saved his life from a tweet from Stephen Fry

University lecturer Mark Jenkins first heard about the clinical trial that saved his life from a tweet from Stephen Fry

Researchers believe that the rapid type of MRI scan that revealed Mark’s tumor could be a reliable method for early detection of aggressive prostate cancer – and lead to a national screening program for the disease that saves hundreds of lives a year.

Currently, the first stage of diagnosis is a PSA (prostate-specific antigen) blood test, which is usually performed by your GP. But this was not designed as a diagnostic tool, and there is a risk of false positives: about a quarter of men who get a biopsy after an elevated PSA level do not have prostate cancer, leading to unnecessary treatment. And it is crucial that about one in seven men with prostate cancer have normal PSA levels.

At present, GPs refer patients with high PSA to an MRI scan. It is this scan that has been refined so that it only takes 15 minutes instead of 40. It has also been adjusted to reveal the revealing signs that a prostate tumor is aggressive.

In the trial, men received the short MRI scan – called a prostagram in a nod to the mammogram for breast cancer – and a PSA test. Remarkably, Prostagram detected aggressive cancers in men who had low PSA scores.

A larger trial is likely to follow next year, and researchers hope the prostagram within ten years will be the basis for mass screening of men aged 50 to 70 years. They do not need to have a PSA test first.

In 2019, when Mark, then 59, got the prostagram, his PSA test was 1.7. For his age group, a normal score is between 0 and 3.5.

“I’m very lucky,” says Mark, who is married to Sandra, 56, and has two daughters. ‘A colleague even said,’ Next time you buy a lottery ticket, can you get me one? ‘

Despite this ‘healthy’ score, his MRI and a later biopsy confirmed a tumor that would have spread rapidly. His best result would then have been radical surgery with the risk of side effects such as erectile dysfunction and incontinence. At worst, he could be dead within a year.

Instead, Mark, now 62, was able to have a less invasive operation to remove his prostate. Today, he still can not believe in his happiness.

“I’m very lucky,” says Mark, who is married to Sandra, 56, and has two daughters. ‘A colleague even said,’ Next time you buy a lottery ticket, can you get me one? ‘ ‘

The vital part of the prostagram is the length of the scan. David Eldred-Evans, a urological surgeon and senior researcher in the trial, explains: ‘We found out which parts of the standard 40-minute scan are important in diagnosing potentially aggressive prostate cancer.

‘There are three parts to the long MRI. We got radiologists to look at each part separately, and then we examined how accurate they were in their diagnoses compared to when they saw all the MRI images.

‘We discovered we did not need one sequence of images focusing on the prostate in general, and we made the other two shorter and faster.

‘The long MRI would produce 3,000 to 5,000 images. In the prostagram there are 1,000.

Researchers believe that the rapid type of MRI scan that revealed Mark's tumor could be a reliable method for early detection of aggressive prostate cancer - and lead to a national screening program for the disease that saves hundreds of lives a year.

Researchers believe that the rapid type of MRI scan that revealed Mark’s tumor could be a reliable method for early detection of aggressive prostate cancer – and lead to a national screening program for the disease that saves hundreds of lives a year.

‘MRI scanners are very mobile and we imagine that the same machines that you see in the hospital are used for mass screening, but in a smaller place – trucks in supermarket or football stadium car parks. And men can get on their feet first, which really helps those who are claustrophobic. ‘

Professor Hashim Ahmed, head of urology at the Imperial College NHS Trust, believes the Prostagram has the potential to form the basis of a ‘rapid, mobile national prostate cancer screening program and could be a game-changer’.

He added: ‘By finding these aggressive cancers at the earliest opportunity, men have the chance to be offered less invasive treatments with fewer side effects.’

Dr. Eldred-Evans says that because it does not look for low-grade cancers – at the age of 70 to 80, half of all men will have a slowly growing prostate cancer, but it will not harm them – the prostagram is less likely to cause straight as much overdiagnosis as a PSA test. The study, which involved 408 men and published in the journal Jama Oncology, found that a prostagram recorded 75 percent of aggressive cancers compared to PSA’s 41 percent.

“Ours is one of the first studies that has even been able to find prostate cancer in men with low PSA,” says Dr. Eldred-Evans. He estimates that the prostagram can prevent 10 percent of deaths due to the disease – thus saving 1,200 lives a year.

Dr. Eldred-Evans says men should still be encouraged to get a PSA test so far, but points out: ‘If you look at the history of the PSA test, it was invented as a marker for monitoring prostate cancer instead of diagnosing it . ‘ Another benefit of a prostagram screening is that there is no need for a rectal examination by a doctor.

Although Mark was otherwise healthy, in 2014 he had urination problems, which may be a sign of an infection, an enlarged prostate or prostate cancer.

He remembers: ‘It got harder to empty my bladder. I had a PSA test but the score was low. Although the urinary problem was annoying, I could live with it. “

When Mark saw Fry’s tweet in November 2018, the problem was ‘deep down’ in his mind.

He taught at the management school at Cranfield University in Bedfordshire and liked the idea of ​​helping academics with their research. Mark had his prostagram in February 2019, and traveled from his home in Ampthill, Bedfordshire, to London.

A week later, he was called to get in for a biopsy – at the time, he was not aware that this was not part of the trial, and “it did not ring the alarm bells”.

Three weeks later, he went to Charing Cross Hospital alone to get the results – to be told he had cancer. “The doctor said it had not spread beyond the prostate, but it would because it was aggressive,” he recalls. ‘I asked if I could write down what he said as I just could not absorb it.’

He was offered various options, including cryotherapy – to kill the cancer cells by freezing them – but chose to have surgery.

“I wanted the cancer removed,” he says. ‘I had just had my 60th birthday and Sandra and I had booked for Alaska for three weeks. I asked the surgeon what he would do and he said he would go on holiday and have surgery afterwards. ‘

Dr. Eldred-Evans says early treatment with fewer side effects is one of the benefits of the prostagram. ‘Another is the reduction of unnecessary surgery for non-aggressive tumors, which poses no danger.

‘If you tell a man that he has a low-grade, slow-growing prostate cancer that will never kill him, he may desperately want it removed and have unnecessary surgery.

Ten years ago, we eliminated most of these cancers: now we only operate on 10 percent. ‘

The next step is a 20 million pound prostagram trial of 20,000 men.

Mark now has a PSA test every six months. He is happy to be checked with the test that failed him because it is good at monitoring patients after treatment.

Mark retired last year and is planning more trips with Sandra. “Our philosophy has always been about getting on with things,” he says. ‘Life is valuable and you do not know what’s just around the corner, so make the most of it.’

Visit: imperial.nhs.uk/prostagram for information on the next Prostagram trial. To help fund it, go to: imperial.ac.uk/giving/donate/prostagram

Omega ur

It is quite difficult to miss the message that omega-3 fatty acids are important for health. But there are other vital omega fatty acids. This week: Omega 7

Available in: Two of the richest sources are macadamia nut oil and seeds and berries from the sea buckthorn plant. It is also found in dairy products and avocados.

What’s new: Omega 7 has been linked to health benefits, including reduced inflammation and blood sugar levels, and relieving dry skin.

In a Korean study, it was found to have an anti-inflammatory effect that helps promote the regeneration of collagen, which gives the skin its structure.

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