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Prostate Cancer Screening – The new, better tests for prostate cancer



Current prostate cancer screening leaves a lot to be desired, as the infamous inaccuracies cause great concern to men and their doctors. Scientists are there. The many recent tests that are currently attempting to prove their accuracy and cost-effectiveness include:

PCA3 (for prostate cancer gene 3). This urine test, obtained after digital rectal examination, can detect a specific type of RNA produced by cancerous prostate cells three times as fast as healthy prostate cells. A low score gives men the certainty that they can delay a repetition.

phi (Prostate Health Index). This blood test measures and combines three different blood chemicals into a single score: Normal PSA, so-called "free" PSA, and a PSA precursor drug known as [-2] proPSA. His manufacturer claims he is three times more accurate than PSA alone, which is perhaps not much to say.

TMPRSS2: ERG Fusion . This urine test looks for an abnormal pooling of two genes found in some prostate cancers and rarely found in cells of men who are free of the disease. Researchers are still trying to determine their value in the clinical setting.

The 4Kscore. This new blood test equals one man's total PSA, free PSA, intact PSA, human kallikrein 2 (hK2) and several other factors. Although more research is needed to demonstrate its benefits, a 201

5 report Reviews of Urology summarizes the results of 10 peer-reviewed studies conducted in Europe and the US so far. The authors concluded that it is promising in distinguishing between lethal and non-lethal prostate cancers, and may one day allow doctors to "safely avoid and develop prostate biopsy in men whose cancers are better left alone." Focus on men who are most likely to benefit.

ConfirmMDx. This genetic test examines normal-looking prostate tissue for cancerous changes in DNA. Biopsies can, at best, take only one percent of the entire prostate, and doctors often fear that some patients may have cancer that the needle just missed. ConfirmMDx looks for telltale epigenetic changes, such as silencing the most important tumor suppressor genes that can signal cancer, even if a biopsy looks completely clean under a microscope. For men who are really clean, they let themselves off by testing for more prostate padding.

PCS or prostate cancer subtype. A team of researchers is still far from ready-time, but has identified three distinct patterns of gene activation in tumor cells called PCS1, PCS2, and PCS3. "One type, especially PCS1, is strongly associated with poorer outcomes," explains Dr. Michael Freeman, Director of Cancer Biology and Therapeutics Research, Cedars-Sinai Department of Biomedical Sciences. In a study published in September Cancer Research Freeman and his team report that these subtypes are independent of the Gleason score, seem to be fairly stable over time, and can be measured by blood tests and prostate sampling. Freeman says there is still a lot of work left. "However, we believe that our classification system could represent a significant advance in the application of precision medicine in the diagnosis of prostate cancer and subtype-specific treatment strategies."


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