Hopes grow for a better prostate cancer test

Researchers say they have developed a urine test that can not only diagnose prostate cancer, but also classify the risk profile of the cancer without a biopsy

It may be a few years away, but the promise of a more effective and less invasive test for prostate cancer is edging closer to reality.

Researchers from the UK say they have developed a urine test that can not only diagnose prostate cancer but also classify the risk profile of the cancer without the need for a biopsy.

The study, published in BJU International, says the test, which looks at a combination of 35 different genes that are considered biomarkers for prostate cancer, is able to provide diagnostic and prognostic information on the cancer status up to five years sooner than current methods.

The researchers used urine samples of more than 500 men, around 100 of whom did not have prostate cancer.

The investigators also tracked the men’s health for an average of six years. In doing so, they determined that the profiles of 23 men whose cancer progressed were significantly different than those whose cancer did not progress.

“This research shows that our urine test could be used to not only diagnose prostate cancer without the need for an invasive needle biopsy but to identify a [person’s] level of risk,” senior researcher Dr Jeremy Clark, from the University of East Anglia, said.

“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 five years before it was detected by standard clinical methods.”

Dr Clark said the test was also able to identify men that were up to eight times less likely to need treatment within five years of diagnosis.

The shortcomings of the commonly used prostate specific antigen (PSA) test are well documented, with false positives occurring in some cases and non-detection of prostate cancer or aggressive cancers in other cases.

Using urine biomarkers offered “a more holistic assessment of cancer status prior to invasive tissue biopsy and may also be used to supplement standard clinical stratification”, the authors said.

“Anything that helps us predict who will have more progressive disease, or who will be less likely to progress, would be helpful,” Dr Durado Brooks, vice president of cancer control interventions for the American Cancer Society, told WebMD.

Dr Brooks said the findings were promising enough to warrant  additional research involving a larger population, adding that a commercially available test would likely be a number of years away.