New Approaches To Diagnosis
This diagnostic process, with all its advantages and disadvantages, is the best we have for now. However, Prostate Cancer UK is investing in a number of research projects that are exploring other routes of diagnosis.
“Recently there have been a number of studies highlighting areas to explore further,” says the spokesperson. “These include imaging using different MRI and ultrasound techniques, tests based on measuring various proteins and DNA changes through blood samples, and tests for measuring tumour cells circulating in the blood.”
One exciting possibility is a blood test, developed by MDNA Life Sciences. Called the Mitomic Prostate Test, the test analyses mitochondrial DNA to determine the presence, or otherwise, of cancer. The company says the test could reduce the number of prostate biopsies by up to 30%.
“Our test won’t be replacing biopsies any time soon – it’s more about giving the doctor information about which patients should be going forward for that biopsy,” explains Harbottle. “This test would be used on men who have slightly elevated, but not super-high, PSA scores – what we call the ‘PSA grey zone’. Three out of four of those men won’t have cancer, so do you want to send them for a biopsy or not? Our test would be used to triage those patients, to see whether they do need an MRI-guided biopsy.”
Currently, the test is only available privately, but the company’s partner, Aspire Pharma, is working to make it available on the NHS.
New Prostate Cancer Blood Test
If you have an abnormal PSA score, your doctor may recommend another newertest that gives a better sense of yourprostate cancer risk. The prostate health index is one such test that is a more accurateblood test and measures your risk for having prostate cancer. Its approvedby the FDA for men who have PSA scores between 4 and 10.
What are the benefits of the PHI test?
- Fewer unnecessary biopsies: Some men who have elevated PSA scores are unsure about getting an invasive biopsy. This tool can be used to better determine whether your risk is high enough to warrant a biopsy.
- More accurate: This test is better at detecting prostate cancer. It can also detect whether you have a more aggressive type of cancer. This information can guide doctors to a more targeted treatment plan for you.
If you score low on the PHI test, your doctor may recommend monitoring youover time to see if your levels rise enough to cause concern.
Prostate Specific Antigen Test
A blood test called a prostate specific antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.
PSA levels also can be affected by
- Certain medical procedures.
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Urine Test Accurately Flags Prostate Cancer
“Our ultimate goal was to determine whether the MyProstateScore test could be a practical, reliable test that could rule out the need for more costly or invasive testing in men referred for a prostate biopsy,” says Jeffrey Tosoian.
You are free to share this article under the Attribution 4.0 International license.
Researchers have found that a new urine test is extremely accurate at detecting aggressive prostate cancer with few false negatives.
The test could have possibly avoided one third of unnecessary prostate cancer biopsies while failing to detect only a small number of cancers, according to a validation study of more than 1,500 patients.
The MyProstateScore test measures levels of cancer-specific genes in a patients urine. Its based on previous research that discovered half of all prostate tumors harbor a certain genetic anomaly in which the genes TMPRSS2 and ERG relocate on a chromosome and fuse togethercreating an on-switch for prostate cancer development.
One of the best current methods for detecting prostate cancer is a blood test for prostate-specific antigen, commonly known as the PSA test. Elevated PSA levels may indicate cancer, but the majority of men with an elevated PSA dont actually have prostate cancer.
The data show that this straightforward, secondary testing approach could reduce the use of more costly and invasive procedures following a PSA test, Tosoian says.
Biopsy During Surgery To Treat Prostate Cancer
If there is more than a very small chance that the cancer might have spread , the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy .
The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.
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Test Ready 35 Years After Validation
Further studies using results from several independent centers should now confirm these findings, note the researchers.
The team expects the test to be available, following regulatory approval, around 35 years after researchers have completed validation studies.
Around 1 in 9 men will have prostate cancer during their lifetime, according to the American Cancer Society .
The ACS estimate that more than 174,000 men will find out that they have prostate cancer and 31,620 will die of it in the United States during 2019.
Although it is a serious disease, most men who have prostate cancer do not die of it. There are more than 3.1 million men alive in the U.S. today who have received a diagnosis of prostate cancer.
Testing for circulating tumor cells is efficient, noninvasive, and potentially accurate, and weve now demonstrated its potential to improve the current standard of care.
Prof. Yong-Jie Lu
When Should I Get Tested
Visit Am I at Risk? to learn more. All men are at risk of prostate cancer, so it is important to talk with your doctor to make an informed decision. Check out our recommended age and testing guidelines, which are based on the NCCN provided recommendations.
Detecting prostate cancer early gives you the best chance of living longer. In fact, more than 99 percent of men survive prostate cancer when it is caught early.
Watch prostate cancer experts, Dr. Lowentritt and Dr. Siegel in this video discuss detection and diagnosis:
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How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer
The PSA test is often used to monitor patients who have a history of prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before other clinical signs and symptoms of prostate cancer recurrence.
However, a single elevated PSA measurement in a patient who has a history of prostate cancer does not always mean that the cancer has come back. A man who has been treated for prostate cancer should discuss an elevated PSA level with his doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.
Genetic Testing For Some Men With Prostate Cancer
Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.
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Biomarkers Available For The Early Detection Of Aggressive Prostate Cancer
Unquestionably, the most commonly used marker for detection of prostate cancer is serum PSA. However, since its introduction in the early 1990s, the limitations of PSA in this regard have been widely recognized., Alternative methods of utilizing PSA, such as PSA velocity, have been reported to improve the specificity for prostate cancer detection., However, recent studies have also suggested that using PSA velocity can result in an increase of unnecessary biopsies, and adds very little to the predictive value of a single PSA measurement alone., Similarly, PSA density has been promoted as another method to improve prostate cancer detection. However, measurement of prostate volume is an invasive, time-consuming procedure. Although both PSA enhancements, at best, provide a slight improvement from PSA alone, these techniques are far from the magnitude of improvement needed to reliably discern between aggressive and indolent forms of prostate cancer.
There Are Risks To Getting Prostate Cancer Tests And Treatments
If your PSA is not normal, you will probably have a biopsy. The doctor puts a needle through the wall of the rectum and into the prostate to take a few samples. Biopsies can be painful and cause bleeding. Men can get serious infections from biopsies, and they may need hospital care.
Surgery or radiation are the usual treatments for prostate cancer. They can do more harm than good. Treatment can cause serious complications, such as heart attacks, blood clots in the legs or lungs, or even death. In addition, 40 men out of 1,000 will become impotent or incontinent from treatment.
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Use In Men Who Might Have Prostate Cancer
The PSA blood test is used mainly to screen for prostate cancer in men without symptoms. Its also one of the first tests done in men who have symptoms that might be caused by prostate cancer.
PSA in the blood is measured in units called nanograms per milliliter . The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesnt have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3.
- Most men without prostate cancer have PSA levels under 4 ng/mL of blood. Still, a level below 4 is not a guarantee that a man doesnt have cancer.
- Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer.
- If the PSA is more than 10, the chance of having prostate cancer is over 50%.
If your PSA level is high, you might need further tests to look for prostate cancer.
To learn more about how the PSA test is used to look for cancer, including factors that can affect PSA levels, special types of PSA tests, and what the next steps might be if you have an abnormal PSA level, see Screening Tests for Prostate Cancer.
How Do I Get Tested
A general practitioner or an urologist can perform a full prostate cancer exam. This would usually include a PSA blood test and digital rectal exam, also called a DRE.
A Prostate Specific Antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions.
A Digital Rectal Exam is a test that is done when a doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
Talk to your general doctor or urologist about receiving a prostate exam. If you do not have a doctor, do not have insurance, and cannot afford a test, find out what free screenings are available in your area on our Free Testing Map. If you do not see a free screening in your area, check back in the fall. Many screenings occur in September, during Prostate Cancer Awareness Month.
Recent research has yielded additional tests that in addition to the PSA and subsequent DRE and Biopsy that can give a doctor more information on to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be. Learn more here.
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Getting The Results Of The Biopsy
Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:
- Positive for cancer: Cancer cells were seen in the biopsy samples.
- Negative for cancer: No cancer cells were seen in the biopsy samples.
- Suspicious: Something abnormal was seen, but it might not be cancer.
If the biopsy is negative
If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.
But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:
- Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
- Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.
Prostate cancer grade
Repeating The Psa Test
A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.
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The Pros And Cons Of The Psa Test
You’ll be entitled to this test if youre aged over 50 . However, the GP will ask you to weigh up its pros and cons. While the PSA test has saved lives – it can help pick up cancer even before you have symptoms – its accuracy is far from perfect.
One in seven men with a normal PSA level may actually have prostate cancer, and in 2% of men that cancer is aggressive. The reverse is true too: three in four men with a raised PSA level don’t have cancer, but will be put through significant worry and sometimes invasive testing as a result.
“PSA is produced by both normal and cancerous prostate cells, and your level can rise with other diseases,” explains Dr Andrew Harbottle, chief science officer at MDNA Life Sciences. “You can have a high reading with things like benign prostatic enlargement,inflammation of the prostate, or even physical exercise, especially cycling. The PSA reading is an indication that there’s something up with the prostate but it’s not necessarily prostate cancer specific.”
The Prostate Cancer UK spokesperson adds that this can cause a lot of anxiety and even unnecessary procedures. For one thing, if your PSA level is raised you may need a biopsy, which can have side effects. For another thing, you might be diagnosed with a slow-growing and low-risk prostate cancer, and end up having treatment you don’t need.
How accurate are prostate cancer tests?
Pros And Cons Of The Psa Test
- it may reassure you if the test result is normal
- it can find early signs of cancer, meaning you can get treated early
- PSA testing may reduce your risk of dying if you do have cancer
- it can miss cancer and provide false reassurance
- it may lead to unnecessary worry and medical tests when there’s no cancer
- it cannot tell the difference between slow-growing and fast-growing cancers
- it may make you worry by finding a slow-growing cancer that may never cause any problems
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What Are The Prostate Cancer Symptoms I Need To Look Out For
In its early stages, prostate cancer may not show any symptoms. Symptoms of early prostate cancer can include:
- difficulty passing urine
- a slow, interrupted flow of urine
- frequent passing of urine, including at night
Symptoms associated with advanced prostate cancer include:
- blood in urine
- pain during urination
- lower back or pelvic pain.
These symptoms are also found in men who may have benign prostatic hyperplasia , a common, non-cancerous enlargement of the prostate gland.
If you experience these symptoms, visit your doctor.
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Simple New Blood Test For Prostate Cancer Determines Presence And Stage Of Cancer With 99% Accuracy
A new blood test for prostate cancer is producing a 99% accuracy ratingprecision that has never before been achieved for a blood test of this particular kind of cancer.
Furthermore, the test can determine the exact stage and progression of the cancer, which also reduces the need for invasive biopsies and scans.
The team behind the breakthrough, involving researchers from Nottingham Trent University and University Hospitals Leicester NHS Trust, determined that changes in the patients immune system could be examined through blood markersspecifically white blood cells.
Our approach not only identifies presence of the disease, but alsocruciallyits clinical significance. We can also do this with higher accuracy than current approaches, said Professor Graham Pockley, Director of Nottingham Trent Universitys John van Geest Cancer Research Center
This will spare men from having unnecessary invasive procedures and help clinicians to decide whether to watch or actively manage patients, even when they are asymptomatic.
With an estimated 1.8 million new cases in 2018 alone, prostate cancer is the fourth most common cancer in the world and the second most common form among men in the United Statesa country that sees almost 200,000 diagnoses every year. It is the most common form of cancer for men in the UK with roughly 47,000 diagnoses annually.
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