Experts urge prostate cancer "man-o-gram"

WASHINGTON Thu Jan 15, 2009 10:34am EST

A radiologist examines breast X-rays after a cancer prevention medical check-up at the Ambroise Pare hospital in Marseille, southern France, on April 3, 2008. REUTERS/Jean-Paul Pelissier

A radiologist examines breast X-rays after a cancer prevention medical check-up at the Ambroise Pare hospital in Marseille, southern France, on April 3, 2008.

Credit: Reuters/Jean-Paul Pelissier

WASHINGTON (Reuters) - Prostate cancer experts urged Congress and the incoming Obama administration on Wednesday to make a major research commitment to find better detection methods, including what they call a "man-o-gram."

Their idea involves a sophisticated ultrasound, magnetic resonance imaging or other method to find dangerous prostate tumors, akin to the common mammogram scans used to find breast tumors.

Dr. Faina Shtern, who heads the Boston-based nonprofit AdMeTech Foundation coordinating the advocacy effort, said $500 million in research funding is needed over five years.

Many men now have a blood test measuring levels of a protein produced by the prostate gland called prostate-specific antigen, or PSA.

Elevated PSA levels may indicate prostate cancer, but benign conditions can also raise levels. Men with elevated PSA often must have an invasive biopsy to test prostate tissue for cancer.

Only about 25 percent to 30 percent of men who have the biopsy actually turn out to have prostate cancer. And experts believe that many cancers detected after PSA screening are so minor they would never present a threat if left untreated.

There is a controversy among cancer researchers about whether PSA screening actually saves lives, with many arguing that it leads to unnecessary surgical and radiation treatment for minor cancers, causing negative side effects.

And because there is no reliable imaging technique to guide the selection of tissue for the biopsies, doctors take random plugs of prostate blindly and may miss tumors.

"Right now what is done essentially is barbaric," Shtern said in a telephone interview.

"We need to be able to find the cancers that are there that are going to be significant -- and only target those," Dr. Thomas Wheeler of Baylor College of Medicine in Houston, one of the experts, said in a telephone interview.

More than two dozen experts from institutions including Johns Hopkins University, Harvard Medical School, the University of Chicago, the University of Miami and Stanford University, joined the effort.

They signed letters to Congress and the U.S. National Institutes of Health, which funds medical research, saying more accurate imaging technology would lead to better guidance for diagnosis, biopsy and minimally invasive treatment.

Shtern said there needs to be a better initial screening test than the PSA test, perhaps a new blood or urine test focused on another biological indicator of prostate cancer.

In the United States, 29,000 men die of prostate cancer each year, making it the No. 2 cause of cancer death in men, behind lung cancer. It is the second most-commonly diagnosed cancer in men worldwide and kills about 254,000 a year.

(Editing by Maggie Fox and Doina Chiacu)

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