Prostate cancer urine test identifies good prognosis patients

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Micrograph showing prostate adenocarcinoma (the most common form of prostate cancer) Credit: Wikipedia

Researchers at the University of East Anglia have shown that a urine test for prostate cancer can identify men at “medium risk” who can safely avoid immediate treatment and benefit from “active surveillance” instead.

A new pilot study published today has revealed how urine biomarkers can show the large amount of cancer in the prostate, focusing with greater certainty on men who need treatment.

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Previously, the team’s urine risk test (PUR) could identify men with both high- and low-risk cancers.

But thanks to some fine-tuning, it can now help men with moderate-risk disease — for whom treatment options were less clear.

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Prostate cancer is the most common type of cancer among men in the UK. It usually develops slowly and the majority of cancers will not require treatment in a man’s lifetime.

The most common tests for prostate cancer include blood tests, a physical exam known as a digital rectal exam (DRE), an MRI scan, and an invasive biopsy.

However, doctors struggle to predict which tumors will develop into a more aggressive form, which makes it difficult to decide on treatment for many men.

Lead researcher Dr Jeremy Clark, from the University of East Anglia’s Norwich Medical School, said: “While prostate cancer is responsible for a significant proportion of all male cancer deaths, it is much more common that men die from it rather than from it.

“Therefore, improvements in diagnosis and outcome prediction for patients with prostate cancer are urgently needed to reduce overdiagnosis and overtreatment during appropriate treatment of men with aggressive disease, especially if this can be done without an invasive biopsy.

“Here at UEA, we have developed a urine test for prostate cancer called the Prostate Urine Risk Test – or PUR for short.

“Danger” here refers to the aggressiveness of the cancer and the possibility of it spreading to other organs, which could eventually kill the patient. But prostate cancer is very complex and risk levels vary widely among men.

“We have previously shown that PUR can identify men with high-risk cancer that requires immediate treatment and also low-risk cancer that has a very low rate of progression and generally does not require treatment.

“But there is a third category of men with ‘intermediate risk’, which falls between these two conditions. About half of men with prostate cancer fall into this group, and the treatment pathways for them have so far been less clear.

“It is known that disease progression in men at average risk is associated with the presence of increased amounts of Gleason type 4 cancer in the prostate. Our study shows that the PUR test can assess the amount of Gleason type 4 cancer without the need for a biopsy.”

“So, PUR can not only measure the presence of aggressive cancer, but it can also measure increased amounts of aggressive cancer in the prostate.

“This means that it can show us which men at average risk might need treatment and which could instead be managed conservatively through monitoring.

“PUR would also be useful in monitoring disease in men who do not currently need treatment, and reporting on the onset and spread of aggressive disease,” he added.

The results of this pilot study will be investigated further in a much larger group of men using samples collected using the prostate examination box that patients receive by mail and samples sent by mail directly for analysis at the University of East Anglia.

Professor Daniel Brewer, from Norwich Medical School at the University of East Anglia and visiting worker at the Earlham Institute said: “Professor Dan Brewer, from Norwich Medical School at the University of East Anglia and visiting worker at the Earlham Institute said: Prostate named PUR which can distinguish whether men should be placed under active surveillance or radical treatment.

“In this paper, we examine in more detail what PUR biological change detects. This is an exciting finding that helps explain why PUR works so well.

He added: “This test is currently being validated in a large, multi-site study with support from Prostate Cancer UK and Movember.”

Dr. said To increase the risk of developing the disease in men with prostate cancer.

“This is important because, for men whose prostate tumor has different levels of Gleason pattern 4, a prostate biopsy is necessary to determine whether men should receive active treatment or be managed with active surveillance.

“We look forward to seeing further validation of this research in a larger study group. If successful, this noninvasive PUR test may be able to support decision-making without the need for an invasive prostate biopsy associated with discomfort and risk of infection.”

This study was led by UEA in collaboration with researchers in the departments of urology and cytopathology at Norfolk and Norwich University Hospitals, University of Hull Teaching Hospitals NHS Trust, Cancer Research Institute, The Royal Marsden and Earlham Institute.

“Urine biomarker PUR-4 positively correlates with the amount of Gleason 4 in human prostate cancer” has been published in the journal life (MDPI) on November 3, 2021.


New prostate cancer urine test shows how dangerous the disease is


Provided by University of East Anglia

the quote: Urine Test for Prostate Cancer Identifies Patients for Good Prognosis (November 3, 2021) Retrieved November 3, 2021 from https://medicalxpress.com/news/2021-11-prostate-cancer-urine-good-prognosis.html

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