- Glucocorticoids are steroids given to 90 per cent of prostate cancer patients
- Treatment is initially effective but stops working after a certain periodÂ
- In one fifth of patients steroids actually trigger aggressive tumour growth
- Blood test developed to signal when treatment has stopped working
- Experts said the discovery could save ‘countless lives
- Prostate cancer affects 42,000 people every year in the UKÂ
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A simple blood test has been developed to signal when a common treatment for prostate cancer has stopped working.
British scientists hope the new test might vastly improve outcomes for men with advanced cancer by making treatment more effective.
They developed the test after discovering that glucocorticoids – steroid drugs given to 90 per cent of prostate cancer patients – can actually accelerate the growth of tumours after a few months of use.
A blood test developed by experts at the Institute of Cancer Research can tell doctors when a common treatment for prostate cancer has stopped being effective
Although the treatment is initially very effective at battling the tumour, after a certain period – which varies patient to patient – it stops working, and then even starts encouraging the cancer to grow.
In one in five patients the steroid eventually drives an aggressive mutation which leads to accelerated tumour growth, the research suggests.
The startling discovery, made by specialists at the Institute of Cancer Research in London, could save countless lives.
The new blood test can precisely tell doctors when the treatment has stopped becoming effective and allow them to stop using it before it puts a patient at risk.
Prostate cancer affects 42,000 people every year in the UK. It is the most common cancer in men, accounting for a quarter of all male cancers.
Twenty per cent of patients die within five years of receiving a prostate cancer diagnosis.
Study leader Dr Gerhardt Attard, whose work was published last night (WEDS) in the journal Science Translational Medicine, said: ‘Glucocorticoids are initially effective, they are great treatments which we have been using for more than a decade now.
‘They make people feel better and their tumours shrink.
‘But in time – it could be a couple of years or less, depending on the patient – the cancer manages to adapt and start growing again.
WHAT IS PROSTATE CANCER?Â
Prostate cancer is the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year.
Prostate cancer usually develops slowly, so there may be no signs you have it for many years.
Symptoms often only become apparent when your prostate is large enough to affect the urethra (the tube that carries urine from the bladder to the penis).
When this happens, you may notice things like an increased need to urinate, straining while urinating and a feeling your bladder has not fully emptied.
However, these signs do not mean you have prostate cancer. It is more likely they are caused by something else, such as benign prostatic hyperplasia (also known as BPH or prostate enlargement).
 Source: NHS Choices
‘In one in five people the treatment might start driving the disease, activating harmful mutations.
‘In the future, we hope to routinely monitor genetic mutations in patients with advanced disease using just a blood test – enabling us to stop treatments when they become disease drivers and select the next best treatment option.’
The study, based on complex genetic analysis of biopsies and blood samples from 16 patients with advanced prostate cancer, shows that glucocorticoids – which are usually given alongside hormone therapy – can in some cases increase the population of cancer cells in a tumour.
Once the body has adapted to the drug, the cancer is driven into a more aggressive form, and starts mutating and accelerating its growth.
But the researchers, who worked with doctors at the Royal Marsden cancer hospital West London and the University of Trento in Italy, found that regular blood tests – or ‘liquid biopsies’ – could track minute changes in the DNA of the tumour.
It means they can act as soon as the cancer starts becoming resistant to the treatment, and withdraw it before it starts mutating into an aggressive form.
Doctors are already using the blood test on all prostate patients at the Royal Marsden, and hope that with more positive results it could be rolled out to all hospitals.
Dr Attard said: ‘We need to confirm these findings in larger numbers of patients but using these types of blood tests could allow true personalisation of treatment for prostate cancer patients, based on the cancer mutations we detect.’
The Prostate Cancer UK and Cancer Research UK charities, which funded the research, last night welcomed the findings.
But they warned that patients treated with glucocorticoids should continue taking their treatment – and not abandon it on account of the discovery.
Prostate cancer affects 42,000 people every year in the UK. It is the most common cancer in men, accounting for a quarter of all male cancers
Dr Matthew Hobbs, deputy director of research at Prostate Cancer UK, said: ‘This research is important as it shows that there might be a new way to monitor how a man’s cancer is changing during treatment and that could help us to pinpoint the stage at which some drugs stop being effective.
‘In the future this could arm doctors with the knowledge they need to ensure that no time is wasted between a drug that stops working for a man and him moving on to another effective treatment.’
Nell Barrie, science information manager at Cancer Research UK, added: ‘It’s vital to understand the genetic twists and turns that offer tumour cells an escape route to become resistant to treatment.’
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