Prostate Cancer Diagnosis May Become Easier with New Urine Test

 

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A new urine test could help diagnose aggressive prostate cancer and determine if men with the disease need treatment sooner rather than later.

The test has the potential to prevent unnecessary, invasive follow-up procedures as well, experts say.

The solution, called the Prostate Urine Risk (PUR) test, was created by researchers at the University of East Anglia and the Norfolk and Norwich University Hospital, both in England.

Researchers say the PUR test can detect prostate cancer and help determine which men are up to eight times less likely to need treatment within five years of diagnosis.

Their findings were published in the journal BJU International.

 
How the new urine test works

The research team used machine learning to assess gene expression in urine samples collected from 537 men.

When they looked at the cell-free expression of 167 genes in urine samples, they found a mathematical combination of 35 different genes that could be used to produce the PUR risk signatures.

The new test uses four PUR signatures to assess noncancerous tissue and risk groups, which lets doctors know if a person is at low-, intermediate-, or high-risk.

The PUR test measures the expression of approximately 30 genes in urine and gauges the rate at which certain functional units in the cell are being produced.

From there, the tests create a score. If this score is high, the man will need treatment sooner. If it’s low, the man will need treatment later, or might not need treatment at all, explained Daniel Brewer, PhD, a senior lecturer at the University of East Anglia and one of the study’s researchers.

 
 
Testing for prostate cancer

Doctors have challenges when it comes to classifying which tumors will become more aggressive.

This makes it more difficult to determine appropriate treatments.

To detect prostate cancer, doctors commonly use the prostate-specific antigen (PSA) blood test or a physical test known as a digital rectal examination, a magnetic resonance imaging (MRI) scan, or a biopsy.

The PSA test is the standard assessment, but about 75 percent of men with an elevated PSA level wind up having biopsies but no cancer, the researchers noted in their study.

The other 15 percent of men who don’t have elevated PSA have prostate cancer — and 15 percent of those cancers are aggressive, the researchers added.

An ideal PUR test candidate would be any man who shows symptoms of prostate cancer such as a raised PSA, or any man who’s on active surveillance for prostate cancer, Brewer told Healthline.

Brewer said there are other urine tests used to diagnose prostate cancer, but none are widespread in clinical use.

“Our current test matches the best performance of other tests in picking up those patients that have clinically significant disease,” he said.

These men need surgery, radiotherapy, or hormone therapy.