Prostate cancer is a big deal. According to the American Cancer Society, nearly 250,000 men will be diagnosed this year and over 34,000 will die. It is estimated that “About 1 man in 8 will be diagnosed with prostate cancer during his lifetime.” That is roughly the same as the 1 in 8 women who will develop invasive breast cancer. Is there A better way to detect prostate cancer than PSA tests?
What’s Wrong with the PSA Test?
For decades the PSA (prostate-specific antigen) blood test has been the first step in monitoring for prostate cancer. It is far from perfect. That’s because it is not specific for cancer.
Normal prostate tissue makes PSA, so a man with an enlarged prostate gland may make extra PSA. Prostatitis can also send PSA into the so-called danger zone. What this means in practical terms is that a lot of men end up with elevated PSA scores who do not have prostate cancer. This can lead to a biopsy, “just to be safe.”
Some men can have prostate cancer that is potentially aggressive but their PSA levels are within the normal range. The bottom line is that this screening test for prostate cancer leaves a lot to be desired.
Urine Tests to Detect Prostate Cancer
Two different research teams are claiming success with new urine tests to detect prostate cancer. Investigators at the University of Michigan and the University of East Anglia in the UK have used genetic markers in urine to identify aggressive prostate cancers.
The lead researcher from the UK is Dr. Dan Brewer. He was quoted by the University of East Anglia (April 27, 2021):
“While prostate cancer is responsible for a large proportion of all male cancer deaths, it is more commonly a disease men die with rather than from.
“Therefore there is a desperate need for improvements in diagnosing and predicting outcomes for prostate cancer patients to minimise overdiagnosis and overtreatment whilst appropriately treating men with aggressive disease, especially if this can be done without taking an invasive biopsy.
“Invasive biopsies come at considerable economic, psychological and societal cost to patients and healthcare systems alike.”
The researchers developed the ExoGrail urine test. They claim that the results are as good as those revealed by biopsy.
Dr. Brewer goes on to state:
“Our new urine test not only shows whether a patient has prostate cancer, but it importantly shows how aggressive the disease is. This allows patients and doctors to select the correct treatment. And it has the potential to reduce the number of unnecessary biopsies by 35 per cent.”
University of Michigan Urine Prostate Seq test (UPSeq):
Investigators at the U of M are also reporting that they have developed a urine test to detect prostate cancer (April 20, 2021):
“‘The problem is that a patient can have multiple areas of cancer in the prostate and these areas may be different than each other,’ explains senior study author Simpa Salami, M.D., M.P.H., an assistant professor of urology at Michigan Medicine. ‘Because of this, both prostate biopsies and MRI scans can miss evidence of aggressive disease. So, this urine test is designed to tell us what’s really happening throughout the whole prostate.’”
Both sets of researchers believe that their test will enable doctors to tell which men require further treatment and who can benefit from active surveillance. It remains to be seen when either or both of these urine tests to detect prostate cancer reach the marketplace. The FDA will have to approve any urine test before it can be sold. In my opinion, the sooner the urine tests can be validated and approved the better.
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