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ecent research has revealed that a
new urine test can detect aggressive prostate cancer cases that need treatment
up to 5 years sooner than other diagnostic methods.
Research
has assessed the effectiveness of a new urine test for prostate cancer.
Researchers
from the University of East Anglia (UEA) in Norwich, United Kingdom, and the
Norfolk and Norwich University Hospital (NNUH) carried out the study.
They
revealed that an experimental urine test, called Prostate Urine Risk (PUR), can
find cancers that will require treatment within
the first 5 years of diagnosis.
The
findings now appear in the journal BJU International.
The
team included Prof. Colin Cooper, Dr. Daniel Brewer, and Dr. Jeremy Clark, from
UEA's Norwich Medical School. Rob Mills, Marcel Hanna, and Prof. Richard Ball,
of the NNUH, provided support.
Looking at biomarkers
To
develop this unique test, the researchers looked at gene expression in the
urine samples of 535 men and determined the cell-free expression of 167
different genes.
They
then established a combination of 35 different genes that the scientists
considered risk signatures, or biomarkers, that the PUR test could look for.
This test is unique in that it can sort people into
different risk groups, thereby demonstrating the aggressiveness of the cancer.
"This
research shows that our urine test could be used to not only diagnose prostate cancerwithout the need for an
invasive needle biopsy but to identify a [person's] level of risk," says
Dr. Clark.
"This
means that we could predict whether or not prostate cancer patients already on
active surveillance would require treatment. The really exciting thing is that
the test predicted disease progression up to 5 years before it was detected by
standard clinical methods."
"Furthermore,"
he adds, "the test was able to identify men that were up to eight times
less likely to need treatment within 5 years of diagnosis."
Prostate cancer is common but slow-growing
According
to the American Cancer Society (ACS), around 1 in 9 men will receive
a diagnosis of prostate cancer during their lifetime. In 2019, the ACS estimate
that there will be around 174,000 new cases of prostate cancer and over 31,000
deaths from the condition.
That
said, most cases of prostate cancer do not result in death. In fact, the 5-year survival rate for localized and regional prostate
cancer is nearly 100%, and even when combined with those who have distant-stage
prostate cancer, the overall survival rate is still 98%.
Not
counting skin cancer, prostate
cancer is the most common cancer among men. Thanks to early detection techniques, doctors can diagnose and treat
many cases early. Because it is a slow growing cancer, tests usually find
before it before it has the chance to spread.
What this test means in a clinical setting
There
are many ways to help identify prostate cancer. Although a
prostate biopsy is the only way to definitely diagnose the condition, there are
a few screening tests that can indicate if a biopsy is necessary.
For
example, the prostate-specific antigen (PSA) blood test can help detect the
possible presence of prostate cancer. Doctors tend to use these results, or a
series of results, to determine if someone needs a biopsy.
Doctors
might also perform a digital rectal exam to see if there are areas on the
prostate that could be cancer. Although it is less effective than a PSA test,
it can sometimes find cancers in people with normal PSA levels.
The
PUR test goes one step further; it not only identifies the presence of cancer
earlier than other tests, it can also help put people into different risk
groups so that doctors can more accurately determine the course of care and
whether to watch and wait, take a biopsy, or start treatment immediately.
"If
this test was to be used in the clinic, large numbers of men could avoid an unnecessary
initial biopsy and the repeated, invasive follow-up of men with low-risk
disease could be drastically reduced."
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