Alan McNeill, TUF research scholar, is heading up a research team who have created an e-Finger (a fingertip probe) which they hope can differentiate between low-risk and aggressive cancers. The e-Finger has already been proven to more accurately assess the mechanical characteristics of the posterior surface of the prostate than a standard digital rectal examination but if it is now proven to differentiate between slow and fast growing cancers the financial implications could be massive.
“We have already used the e-Finger to measure the stiffness of the prostate and detect whether there is cancer or not,” said Alan. “We now want to take the e-Finger to men attending with a raised PSA. If the e-Finger measures well in differentiating between benign (low risk) cancer and significant cancer it may be a simple, cheap way of assessing men with a raised PSA and providing a risk stratification of whether they are likely to have cancer or not.
“Currently, if men have a raised PSA they are referred to hospital and either go straight for a biopsy or have an MRI before the biopsy. But 50 per cent of men who have a biopsy in our hospital will not have prostate cancer. Whilst an MRI prior to biopsy will allow some men to be reassured and avoid the biopsies the difficulty is that MRIs cost several hundreds of pounds, and many hospitals currently lack the imaging capacity to perform all of the additional MRI scans that will be required. The e-Finger will be cheaper than doing an MRI for all men with a raised PSA who are being considered for prostate biopsy and will free up the MRI for other indications. Consequently if the e-Finger works as we hope, it could save the NHS millions of pounds.”
The e-Finger examination would be similar to a prostate rectal examination. The e-Finger device, which was developed in collaboration with the mechanical engineering department of Heriot Watt University, is worn under an examination glove on the index finger. The prostate is palpated through the front wall of the rectum and the examiner then feels the back surface of the prostate.
“A lot of GPs say they don’t do enough examinations to feel confident about what they are feeling,” said Alan. “But if the device works it gives a risk stratification measurement and is objective, rather than subjective examination performed by a GP who doesn’t feel confident.”
Recruitment for the project has now begun and the team at the Western General Hospital in Edinburgh, who are part-funded by TUF with support from the John Black Charitable Foundation, hope to recruit 800 men over the next couple of years. Alan said the project is both ground-breaking and innovative.
“Differentiating between low risk and aggressive cancer is a novel concept and preliminary studies have shown very encouraging results detecting significant cancers. But the association between the grade of cancer and the findings needs to be examined in a large cohort of patients.
“We are hoping to have some results in 2-3 years but to have the device in a market place that is dynamic is more like five years. The initial results are promising and this could have huge implications for patients and the NHS and be applied in other areas, not just prostate cancer.”
