Prostate cancer test promising
Urinalysis might lead to more-precise diagnoses.
Researchers said Thursday they are closer to developing a urine test that can better detect which prostate cancers are aggressive and potentially life-threatening.
Such a test would be welcome. More than half of prostate cancers are slow growing and unlikely to kill, and experts say watchful waiting is the best option for many patients — especially if doctors were better able predict their course.
Currently, biopsies — in which several small tissue samples are taken from different parts of the prostate — are used to try to identify large, aggressive tumors.
The hope is that an accurate urine test might in some cases replace the need for biopsy, while easing fears in men who opt to delay or forgo treatment.
The study included 401 men, about 70 from San Antonio, who were picked because doctors thought their cancers were low-risk and good candidates for watchful waiting. Of those, the urine test found about 10 percent had more aggressive disease, making them candidates for surgery — results that were confirmed by biopsy.
Prostate biopsies are invasive and don’t always pick up all of the cancer. Post-digital-rectal exam urine collection is much less invasive. If a urine-based diagnostic test could be developed that could predict aggressive disease or disease progression as well as or better than a biopsy, that would be ideal.
The urine tests, PCA3 and T2-ERG, together provide a kind of genetic profile of the cancer. Added to the current PSA test, a digital rectal exam and factors such as age, race and family history, they could help doctors make more accurate predictions if the results are confirmed in the larger study.
Bottom Line: Ultimately, doctors would like to be able to have these tests and be able to confirm the man has a low-risk cancer which means less treatment, less complications, less side effects, and longer survival. Instead of seeing the patient every six months and doing a biopsy every two years, your doctor might tell men with low risk cancers: “You have a low-risk cancer, see you in five years.”