Ongoing Research & Future Perspectives
Many proteins have been suggested as candidate biomarkers however, to date, no protein biomarkers have entered clinical use for prostate cancer . Additional studies must be performed to better understand the potential and accuracy of proteins as a diagnostic biomarker in urine for prostate cancer testing. Recent research by the University of East Anglia has shown that a prostate cancer-urine test can help identify prostate cancer tumors.
The Prostate Urine Risk test, which looks for certain biomarkers in urine could identify men with high, intermediate, or low risk for prostate cancer . Further development of the test can now help determine disease aggressiveness. The model named ExoGrail combines the measurement of a protein-marker called EN2 and 10 other genes measured in urine. This approach can help direct treatment options, by suggesting which patients need to undergo treatment immediately and those who can be transferred to active surveillance. Further validation of this research will be conducted in a larger study cohort, but the current findings are promising for urinary prostate cancer research .
Importantly, to use urine for clinical applications, the collection, transport, and storage of urine should be optimized. Additionally, first-void urine has shown to be valuable for prostate cancer detection, highlighting the potential need to accurately collect this fraction .
New Prostate Cancer Tests Using Urine Samples
The urine samples give information not only on gene fragments of prostate cancer but also on the risk factors. The University of Michigan developed another urine-based test that can reduce the number of negative biopsies by 50%.
This same new test was found to be 97% accurate in identifying cancers later found to be aggressive in biopsies. This means that the urine test can identify prostate cancer earlier than other tests and also divide people into different risk groups, allowing the doctor to accurately determine the treatment path watchful waiting, active surveillance, biopsy or immediate treatment.
In the following video, Dr. David Samadi discusses the benefits of this new prostate cancer test:
Transmembrane Protease Serine : Erg Gene Fusion Via Mi
The gene fusion of TMPRSS2 and ERG creates a overexpression of the ERG oncogene driven by androgens.This TMPRSS2:ERG gene fusion occurs frequently in PCa carcinogenesis.The MiPS adds TMPRSS2:ERG mRNAto PCA3 and serum PSA to create a risk score.Its NPV for ruling out any PCa is 90% but its NPV in ruling out clinically significant PCa is unknown,although it is likely higher than 90%.Tomlins et al.showed that MiPS with the PCPT risk calculator had superior predictive accuracy compared to the PCPT risk calculator alone,demonstrating an AUC of 0.779 vs.0.707for detecting clinically significant PCa.They found that a MiPS threshold of< 15%would have avoided 36%of biopsies while missing 19 clinically significant PCa.On DCA,there was a clear net benefit of MiPS relative PCPTRC for detection of clinically significant PCa.
In Europe,Leyten et al.,in a study with 443 men undergoing biopsy for PSA> 3 ng/mL,found that adding the MiPS score to the ERSPC risk calculator increased the predictive accuracy for any PCa.They did not calculate AUC for MiPS predicting clinically significant PCa but did show that TMPRSS2-ERG was a significant predictor for Gleason score,although PCA3 was not.The investigators also showed that combining PCA< 25 and TMPRSS2:ERG< 10 would have avoided 35% of biopsies while missing 11 cases of clinically significant PCa.Both of these studies suggested that MiPS has utility in reducing biopsies without missing many cases of clinically significant PCa.
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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
Improving Upon The Psa Test
The limited reliability of the PSA test, and its lack of specificity for prostate cancer, has led to sharp disagreement over the use of the PSA test as a routine health screening measure for men of a certain age. What everyone does agree upon is the need for better markers of prostate cancer. To date there are no perfect biomarkers that identify only high-risk prostate cancer. But each year progress is made toward such a goal. Today, the University of Michigans Department of Pathology MLabs will begin offering the MiPS urine test that is ultra specific for prostate cancer. The MiPS test scans urine samples for two molecular markers that are distinct to prostate cancer. One marker is a snippet of RNA made from a gene that is overactive in 95 percent of all prostate cancers. The second marker is RNA that is made only when two genes abnormally fuse. The presence of this fusion RNA in a mans urine is ultra specific for prostate cancer.
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How Does The New Noninvasive Urine Test Work
This non-invasive urine test detects cancer cells and genetic material shed from the prostate and other parts of the urinary tract. This material can be isolated and then analyzed by making use of advanced technology.
Some prostate urine test methods describe that, before taking the sample, we should perform a prostate massage. This method is meant to dislodge prostate cells into the urinary tract, increasing the tests sensitivity. However, it appears that our technology is good enough and does not require this step. Thus, males should only collect their urine samples and send them or carry them to the laboratory.
This was the case in most recent studies. Diagnosed prostate cancer patients and other patients with benignant prostate conditions took their samples. They did not undergo a prostate massage before, and it was still possible to make the diagnosis.
This test works by detecting a molecular signature in the urine sample. RNA is sampled and sequenced using a technology known as mass spectrometry. With this technique, it is possible to measure different substances in the urine accurately. Unlike patients with a benign condition, those with prostate cancer displayed a diverse array of metabolites and RNA sequences .
Thus, what this new test does is detecting the fingerprint of prostate cancer in the urine. No previous prostate massage is required, making the technique noninvasive and more comfortable for males.
Advantages And Prospects Of The Urine Studies
Urine is readily available and can be used to detect either exfoliated cancer cells or secreted products. The major advantages of urine-based assays are their noninvasive character and ability to monitor PCa with heterogeneous foci. The purpose of urine-based screening tests for prostate cancer is to find cancer cells from which markers can be extracted or to find released proteins or nucleic acids that are modified compared with the forms in healthy men. Urine, with less complexity than serum and relatively high thermodynamic stability, is a promising study medium for the discovery of novel biomarkers in prostate cancer .
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Fighting Prostate Cancer: One Man At A Time And Torch Prostate Cancer
The Prostate Cancer Torch and Fighting Prostate Cancer, One Man at a Time provides an opportunity to bring awareness and education to rural communities the United States and Canada. As the epic motorcycle ride throughout the Great Lakes region and Canada bringing awareness to the importance of early detection of prostate cancer.
Erg Fish Clinical Assay
ERG gene rearrangements are present in a subset of prostate cancers and detection of such rearrangements can aid in the classification and diagnosis of prostatic adenocarcinoma. A clinical FISH assay to detect ERG rearrangements has been developed under the GU Service line initiative and is now available for use to assist in the diagnosis of neuroendocrine prostate cancer, in the differential diagnosis of poorly differentiated prostate cancer from poorly differentiated urothelial cancer, and diagnosis of metastatic ERG positive prostate cancer . For further details of this assay, .
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Unnecessary Prostate Cancer Biopsies Could Be Reduced By 60 Per Cent Thanks To New Research From The University Of East Anglia Researchers Have Developed New Methods To Identify Biomarkers For Prostate Cancer By Combining Information From Multiple Parts Of Urine Samples
Prostate cancer is more commonly a disease men die with rather than from
It is hoped that the breakthrough could help large numbers of men avoid an unnecessary initial biopsy. The reseach has been .
Prostate cancer is the most common cancer in men in the UK. It usually develops slowly and the majority of cancers will not require treatment in a mans lifetime. The most commonly used tests for prostate cancer include blood tests, a physical examination known as a digital rectal examination , an MRI scan or a biopsy. Lead author Shea Connell from UEAs Norwich Medical School, said: Prostate cancer is more commonly a disease men die with rather than from. Current practice assesses a patients disease using a PSA blood test, prostate biopsy and MRI. But up to 60 per cent of men with a raised PSA level are negative for prostate cancer on biopsy. So it is clear that there is a considerable need for additional, more accurate, tests.
Senior author Dr Daniel Brewer, from UEAs Norwich Medical School, said: Its still very early days for this research, but if ExoMeth were validated in a future study with many more patients, we could see an approximate 60 per cent reduction in unnecessary biopsies in around five years.
University of East Anglia
Use In Men Already Diagnosed With Prostate Cancer
The PSA test can also be useful if you have already been diagnosed with prostate cancer.
- In men just diagnosed with prostate cancer, the PSA level can be used together with physical exam results and tumor grade to help decide if other tests are needed.
- The PSA level is used to help determine the stage of your cancer. This can affect your treatment options, since some treatments are not likely to be helpful if the cancer has spread to other parts of the body.
- PSA tests are often an important part of determining how well treatment is working, as well as in watching for a possible recurrence of the cancer after treatment .
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Prostate Cancer: New Urine Test Hope
Health editor, BBC News online
An experimental new urine test can reveal if men with early prostate cancer will probably need aggressive therapy or can be left untreated but monitored, UK researchers say.
Current PSA blood tests cannot do this, meaning many men experience unnecessary worry, investigations and treatment.
The prostate urine risk test looks for genetic markers to give a more accurate assessment.
Trials in 537 patients suggest it can reliably sort men by risk.
It is one of a number of new tests including other urine-based ones, as well as blood tests and scans scientists are pursuing to improve prostate cancer detection.
A combination of checks rather than one single test may ultimately prove to be the best approach, experts say.
Prostate cancer is the most common cancer affecting men in the UK, with 47,000 new cases a year.
Preparation Of Europium Chelate Conjugated To Secondary Antibody
We have previously reported conjugation of a novel europium chelate to anti-mouse IgG antibody. Briefly, for the conjugation reaction, 100 g anti-mouse IgG antibody was exchanged into NaHCO3 buffer and then mixed with 15 molar excess of the BHHBTEGSB ligand. After incubation for 1 h at 37 °C, 50L of ethanolamine solution were added to stop the reaction, then the reaction mixture passed through a Sephadex column using Tris Buffered Saline containing 5% glycerol as an eluent to purify the conjugated Ab from excess of europium ligand. The fractions corresponding to labelled conjugates were collected according to their absorbance detection measured by an Eppendorf BioPhotometer .
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A New Urine Test Can Help Aid Early Detection Of And Treatment Decisions About Prostate Cancer A Study From The University Of Michigan Comprehensive Cancer Center And The Michigan Center For Translational Pathology Finds
The test supplements an elevated prostate specific antigen, or PSA, screening result, and could help some men delay or avoid a needle biopsy while pointing out men at highest risk for clinically significant prostate cancer.
The test looks for a genetic anomaly that occurs in about half of all prostate cancers, an instance of two genes changing places and fusing together. This gene fusion, TMPRSS2:ERG, is believed to cause prostate cancer. Studies in prostate tissues show that the gene fusion almost always indicates cancer. But because the gene fusion is present only half the time, the researchers also included another marker, PCA3. The combination was more predictive of cancer than either marker alone.
Results of the study appear Aug. 3 in Science Translational Medicine.
“Testing for TMPRSS2:ERG and PCA3 significantly improves the ability to predict whether a man has prostate cancer,” says lead author Scott Tomlins, M.D., Ph.D., a pathology resident at the U-M Health System. “We think this is going to be a tool to help men with elevated PSA decide if they need a biopsy or if they can delay having a biopsy and follow their PSA and urine TMPRSS2:ERG and PCA3.”
Prostate biopsies are done with a needle in an office setting, but they do pose some discomfort and risk to the patient. In addition, a biopsy can offer an incomplete picture since urologists are testing the prostate as a whole, rather than a specific lesion.
Diagnostic Tools Of Melanoma
Visual inspection is the most common diagnostic technique for melanoma. A popular method for remembering the signs and symptoms of melanoma is the ABCDE, including five critical fundamentals: asymmetry, border, color, diameter, and enlarging. A lesion that is suspected to be melanoma typically has features like asymmetry, irregular border, and multiple colors. Moles that are greater than 6 mm are more likely to be melanomas than smaller moles, and moles that evolve might be a concern. Although these standard criteria are often used for proper identification of potential melanomas, conditions exist that do not fulfill these criteria but are still cases of melanoma. For instance, many melanomas present as lesions smaller than 6 mm in diameter.
In addition to the ABCDE, an important method to aid in the diagnosis of melanotic lesions is dermoscopy. A dermatoscope allows for the magnification of lesions while simultaneously providing a polarized light source rendering the stratum cornea translucent. It has advantages such as decreasing the number of biopsies of benign skin lesions and providing increased diagnostic accuracy of melanoma.
Tests To Diagnose And Stage Prostate Cancer
Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.
If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.
The actual diagnosis of prostate cancer can only be made with a prostate biopsy .
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Preparation Of Sers Nanotags For Raman
Gold nanoparticles were synthesized by the reduction of HAuCl4 by citrate solution as reported by Frens. SERS nanotags were prepared as our previous report. Briefly, 20 µL of 1 mM Raman reporter 5,5-Dithiobis was added into the AuNPs and incubated at room temperature overnight with shaking to form AuNPs-DTNB. The mixture was then centrifuged at 7000 rpm for 5 min to remove residual reactants and re-suspended in 1 mL Milli-Q water. Antibody with DTSSP linker was prepared by mixing 10 µl 1 mg/ml of DTSSP and 20 µl of 0.15 mg/ml MIL-38 at 300 rpm and shaking in RT for 30 min. SERS nanotags was thus prepared by mixing MIL-38-DTSSP and AuNPs-DTNB at 300 rpm shaking in RT for 30 min and at 4 overnight. The mixture was centrifuged to remove free antibodies and then mixed with BSA in 0.1 mM PBS to block non-specific binding at RT for 1 h under 350 rpm shaking. After removing the free BSA, AuNPs-DTNB -MIL-38 antibody were ready to use in RiA.
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Retrospective And Prospective Urine Cohorts
A multicenter retrospective study was conducted at San Francisco General Hospital with Institutional Review Board approval to collect and test archived urine sediments to identify and validate urine biomarkers for PCa diagnosis and prognosis. The prospectively designed, retrospective study used pre-biopsy urine samples randomly chosen from sample archives at the Cooperative Human Tissue Network Southern Division and Indivumed GmbH . This study followed the REMARK guidelines. With prior ethical approval and patient consent for future studies, urine samples were collected from 520 patients who had elevated PSA or symptoms and were diagnosed to have prostate cancer by routine biopsy after the urine collection. The patients were recruited from July 2004 to November 2014 with follow-up through June, 2015.
During the follow-up period, all the patients who had radical prostatectomy or other treatments were assessed periodically for biochemical recurrence and cancer metastasis .