Prostate Cancer Urine Test on the Horizon

29 August 2011

There is promising new research in the area of prostate cancer detection that I’d like to share with you. As you know, Prostate Specific Antigen (PSA) screening is the universal standard for early detection of prostate cancer in men. I, along with my colleagues in the medical community, routinely stress the need for men to begin PSA testing at the age of 50. For men considered high risk, including African Americans or those with a genetic history of prostate cancer, that age bumps up to 40. Early detection is the best way to beat prostate cancer.

Researchers at the University of Michigan are now exploring the use of a urine test to aid in the detection of prostate cancer. The test is designed to identify two genetic markers in men: TMPRSS2:EG and PCA3. Both bio-markers are known to be present in prostate cancer patients. The first, caused by two genes switching places and then fusing together, is believed by some to be the cause of prostate cancer, but it is only found in about half of cancer patients. To strengthen the test, the detection of the second marker, PCA3, is included. The recent study looked at 1,312 men with elevated PSA level and subsequent prostate removals, comparing the results of their urine tests with the results of their biopsies. Based on the correlations found in the results of each, researchers believe the test may be an effective tool in detecting a man’s prostate cancer risk.

Further, what the makers and researchers of the new urine test hope to achieve is the ability to stratify, or categorize, the level of a man’s risk of prostate cancer. Prostate cancer biopsies in the U.S. exceed one million annually. If a test such as this can show a man’s risk of prostate cancer to be very minimal, a biopsy may be postponed. Similar tests of these two genetic markers have been performed in the past and there is some evidence that combining such a test with the PSA blood test may result in a better prediction of prostate cancer. That being said, I believe great caution must be used with its integration into prostate cancer screening.

Erring on the side of caution is always best. In dealing with my prostate cancer patients, I would much rather perform a biopsy and deliver peace of mind to a man than be too conservative in my approach. Prostate cancer is a silent killer that does not step gingerly. I believe it should be treated with the same force that it treats us. Early detection and early removal is my firm approach. But what encourages me about research like this is the potential to strengthen our prostate cancer detection abilities.

Unfortunately, African American men who are among the highest at risk of prostate cancer were not included in this study. African American men are three times as likely to be diagnosed with prostate cancer as their non-Hispanic Caucasian counterparts. I’m hopeful that research will soon be conducted on the effectiveness of genetic marker urine testing on this critical part of our population.

This new urine test, to be produced by Gen-Probe, is not yet available to the public, nor has it been submitted for FDA approval yet. The University of Michigan will soon be offering the test and, I believe, its effectiveness will be made clearer in the coming months and years.

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