A new urine test can tell the difference between an enlarged prostate or prostate cancer. This test from Gen-Probe is not approved in the United States but is approved in some European countries.
If a man has a noncancerous condition of the prostate a PSA (prostate-specific antigen) tumor marker test can rise. This rise in the PSA test can lead to a biopsy of the prostate. This biopsy is the only way to determine if the PSA test is picking up a cancer or an enlarged prostate that is not cancer.
The urine test is different because it detects genetic material--RNA--from prostate cancer gene 3 or PCA3. PCA3 is only found in the prostate and when the cells become cancerous the cells express more PCA3 RNA than normal cells. It is independent of the PSA test and works differently to detect cancer.
This test is not designed to replace the current PSA tumor marker but it can do something that the PSA cannot. It can be a separate tool used to determine if cancer does exist. Its not a perfect test but it can help out a few situations. If a man has a low PSA but wants some extra reassurance without getting a biopsy this test could be added along with the PSA. Also, it can help men that have a negative biopsy but a rising PSA decide whether they would like a second biopsy.
Urine tests are already used to detect bladder cancers and some kidney cancers so this test could provide the patient and the doctors with more information and better decision making tools.
1. While the test has not yet been approved by the FDA, it is available in the United States, and statements by the director of the testing laboratory, Dr. David Bostwick, indicate that there is a very high rate of coverage by insurers. (That could be confirmed in advance.) Information about the test is available at:
http://www.bostwicklaboratories.com/about/PCA3.html
This is a improved follow-on to an earlier version at the same lab known as uPM3.
This test appears to be proving a substantial advance in the struggle to determine at least two key questions: whether biopsies are necessary following a PSA test, and whether prostate cancer may be present even after negative biopsies.
We were informed about both the uPM3 and PCA3 tests by Dr. Bostwick at the National Conference on Prostate Cancer 2005 (Washington, DC) and the International Conference on Prostate Cancer 2006 (Reston, Virginia). Tapes and DVDs of those talks area available at www.cancer-foundation.org.
It is good to see that the media is beginning to publicize this great development.
Jim Waldenfels (Web site: http://www.mycancerplace.com/profile.php?id=147 )
Posted at 9:58PM on Nov 30th 2006 by Jim Waldenfels