Suspicious findings from prostate cancer screening are often followed by a procedure most men would prefer to avoid: a prostate biopsy. But what if biopsies actually could be avoided on the basis of non-invasive test results? Screening tests are moving in that direction, with some intriguing results. One of them, the Prostate Health Index blood test, combines measures of three forms of prostate-specific antigen (PSA) into a score that helps doctors predict if a cancer is likely to progress, with an aim to circumvent biopsies that aren’t necessary. Another non-invasive test, called the PCA3 assay, measures genetic evidence of aggressive cancer in urine samples, and generates a score designed to help doctors assess the need for a repeat biopsy. Though approved by the Food and Drug Administration, these tests aren’t perfect, and experts question the reliability of the PCA3 test in particular.
Now researchers are considering the value of a new test that also looks for evidence of high-grade prostate cancer in urine. The results were reported in the Journal of the American Medical Association last April. Called the “urine exosome gene expression assay,” it measures not just PCA3 but also two other genes associated with high-grade disease: ERG and SPDEF. The test combines those measures into a diagnostic score that “could help determine if an initial prostate biopsy is warranted,” said its co-developer Dr. Michael Donovan, a pathologist and researcher at The Mount Sinai Hospital in New York. According to Donovan, the goal is to limit the number of prostate cancer biopsies, which are costly, painful, and prone to hospital-acquired infections.
The study enrolled 1,563 men from 22 community and academic urology clinics in the United States. According to results with a final grouping of 519 men, assay scores over a “cut-off” value of 15.6 predicted high-grade cancer correctly 92% of the time. The assay didn’t always get it right: 12 men were misdiagnosed as having low-risk cancer when they in fact had higher-grade disease.. But most of those tumors, Donovan said, fell into an intermediate-risk category that some doctors would consider eligible for active surveillanceinstead of treatment.
The genes measured reside in small vesicles called exosomes that are secreted by prostate cells. For the test, men have to provide a “first-catch” urine sample. That’s because prostate exosomes are concentrated in the initial stream and numbers decline as urination continues. “In our view, the assay can be combined with other standard-of-care factors during clinical decision making,” Donovan said. “Right now, it’s designed for men who have never had a biopsy, but we’re also moving towards studies that will assess its use in other settings, such as active surveillance.”
Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org, cautioned that while the number of non-invasive tests for prostate cancer diagnosis is growing, these are still early days in their development. “Until we better understand how these tests correlate with the behavior of the prostate tumors they can help diagnose, they remain very much in the research sphere,” he said.
Related Information: 2016 Annual Report on Prostate Diseases
Below are spiritual recipe for health and wellness: Matthew E. McLaren
I pray that out of his glorious riches he may strengthen you with power through his Spirit in your inner being, so that Christ may dwell in your hearts through faith. And I pray that you, being rooted and established in love. Ephesians 3:16-17 NIV
Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours. Mark 11:24 NIV
Now faith is confidence in what we hope for and assurance about what we do not see. Hebrews 11:1 NIV
For we live by faith, not by sight. 2 Corinthians 5:7 NIV
May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit? Romans 15:13 NIV
But when you ask, you must believe and not doubt, because the one who doubts is like a wave of the sea, blown and tossed by the wind. James 1:6 NIV
And without faith it is impossible to please God, because anyone who comes to him must believe that he exists and that he rewards those who earnestly seek him. Hebrews 11:6 NIV
Though you have not seen him, you love him; and even though you do not see him now, you believe in him and are filled with an inexpressible and glorious joy, for you are receiving the end result of your faith, the salvation of your souls. 1 Peter 1:8-9 NIV
Then Jesus said, “Did I not tell you that if you believe, you will see the glory of God?” John 11:40 NIV
Because you know that the testing of your faith produces perseverance. James 1:3 NIV
Jesus said to her, “I am the resurrection and the life. The one who believes in me will live, even though they die; and whoever lives by believing in me will never die. Do you believe this?” John 11:25-26 NIV
Accept the one whose faith is weak, without quarreling over disputable matters. Romans 14:1 NIV
But you, man of God, flee from all this, and pursue righteousness, godliness, faith, love, endurance and gentleness. 1 Timothy 6:11 NIV
For everyone born of God overcomes the world. This is the victory that has overcome the world, even our faith. 1 John 5:4 NIV
If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but do not have love, I am nothing. 1 Corinthians 13:2 NIV
I have set my heart on your laws. Psalm 119:30 NIV
“Go,” said Jesus, “your faith has healed you.” Immediately he received his sight and followed Jesus along the road. Mark 10:52 NIV
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