Annually, about 26.000 American men die from prostate cancer. This is why it is extremely important to use effective methods to accurately diagnose prostate cancer, at an early stage.
New prostate cancer tests that go beyond the standard PSA test are popping up throughout the country promising more specific information that both the patient and doctor want and need to know in individualizing treatment to get the best outcome possible.
These new tests involve using blood, urine and tissue samples with the purpose not only to determine if a man has prostate cancer but also to pinpoint the exact location, grade, and aggressiveness of cancer, therefore optimizing the best course of action to take. A urine test can be used not only to diagnose prostate cancer without using an invasive biopsy but also to determine the level of risk.
PSA blood test has been used as a traditional way of diagnosing prostate cancer. PSA (Prostate-specific antigen) is a protein produced by the prostate gland. An elevated PSA level may indicate the presence of prostate cancer. But, there are also other factors that can influence the PSA level. Prostate infections, BPH or the use of some medications may result in a high PSA level. The usual follow-up after an elevated PSA level is a needle biopsy. Researchers found that less than half of those biopsies found cancerous cells. Also, many of the cancers found are indolent, not likely to spread or cause life-threatening problems.
In this context, it was considered that, in many cases, men need to go through an unnecessarily painful process of cancer diagnosis. Many of the new tests, including the urine test, aim to reduce the number of unnecessary biopsies that more than one million men undergo each year.
One such new test is called the 4Kscore, developed at Memorial Sloan-Kettering Cancer Center in New York. This test analyzes four different types of PSA-related proteins in blood samples calculating from 1% t0 100% the likelihood of finding aggressive cancer.
Prostate Health Index, or PHI, from Beckman Coulter, Inc. is another PSA-based test that can calculate if a biopsy will detect prostate cancer but not be able to tell the cancer’s aggressiveness.
The urine samples give information not only on gene fragments of prostate cancer but also on the risk factors. The University of Michigan developed another urine-based test that can reduce the number of negative biopsies by 50%.
This same new test was found to be 97% accurate in identifying cancers later found to be aggressive in biopsies. This means that the urine test can identify prostate cancer earlier than other tests and also divide people into different risk groups, allowing the doctor to accurately determine the treatment path – watchful waiting, active surveillance, biopsy or immediate treatment.
In the following video, Dr. David Samadi discusses the benefits of this new prostate cancer test:
The urine test, called Mi-Prostate Score (MiPS), incorporates blood PSA level and two molecular RNA markers that are considered specific for prostate cancer. Cancer occurs when genes are combined in a different, abnormal way. This test looks for these combinations, that are considered risk signatures, or biomarkers, for prostate cancer.
One marker is a snippet of RNA made from a gene (PCA3) that is overactive in almost all prostate cancers. The second biomarker is considered to be an abnormal fusion between two genes: (TMPRSS2 and ERG). The presence of these two biomarkers, or just one, in the urine, can accurately diagnose prostate cancer.
This revolutionary test is not only useful for prostate cancer screening, but also for prostate cancer prediction. It is surprising that this test can predict prostate cancer progression years before it can be detected using other diagnostic methods.
The purpose of developing new tests to detect and determine the location and treatment of prostate cancer is to provide doctors with better technology that makes them able to analyze the genetic makeup of tissue from a biopsy. When a man is told his PSA level is elevated, he wants to know exactly what needs to be done in order to prevent any spread of cancer and to reduce side effects as much as possible. These new tests, especially the urine test, represent medical advancements doctors will rely on when diagnosing and predicting prostate cancer progression.
Patients newly diagnosed with prostate cancer and elevated PSA can contact world-renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, by visiting ProstateCancer911.com or calling 212.365.5000 to set up a consultation. Always remember, early detection saves lives!