Researchers at the University of Michigan Rogel Cancer Center are in the process of developing a urine test which may be able to screen for prostate cancer more effectively. Top experts talk to SurvivorNet about the possibilities.
Published May 1, 2021
The future of prostate cancer screening may see some changes in the near future thanks to a new urine test that’s being created by researchers. The Urine Prostate Seq Test (UPSeq) is a tool being developed at the University of Michigan Rogel Cancer Center which aims to make prostate cancer screening more thorough and affordable for patients.
“The rationale for our work is to figure out a way to develop a test that may capture everything that’s happening in the prostate,” Dr. Simpa Salami, a urologist at Michigan Medicine and a member of the University of Michigan Rogel Cancer Center, tells SurvivorNet in an interview. “Ideally you want that test to be simple, cheap, and easy to do. We found that a urine-based approach could capture what is going on in the entire prostate.”
It’s worth noting that the UPSeq test is still in the early phases of being studied, so therefore not available to patients. However, if results continue to be promising this could be a game-changer for the future of prostate cancer screening. By taking samples of men’s urine after a prostate exam, researchers examine 15 strands of RNA to try to find specific genes associated with prostate cancer. In the early phases of this test, researchers say it’s been able to detect cancers that need to be treated with high accuracy. “This is a first report so it’s still early,” Dr. Salami explains. “We’re still optimizing the test and trying to reach the test in different patient populations, but so far it is promising.”
While initial results of this test are promising, it’s too early to say whether it’ll be the future of prostate cancer detection. Experts agree that the goal is to find a screening method which is better than the PSA test which is currently used.
“There’s a lot of tests out there right now that outperform PSA,” Dr. Stephen Freedland, director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai, tells SurvivorNet. “While this is interesting it’s really early and needs a lot more validation first. Not just compared against PSA but compared against PSA that includes age, rectal exam findings and prostate size. There’s a lot of factors that we already know effect the likelihood of finding cancer. So while beating PSA is step one, simply beating PSA doesn’t mean it’s ready for primetime use. There are further steps and further analysis.”
Currently, the tool used to detect signs of prostate cancer is through the PSA test, a blood test, but experts note that there are still a few flaws with this screening method. Through the PSA test, doctors examine whether PSA, or protein-specific antigen, is present in the blood. While a small amount of PSA is certainly normal to be present in the blood, a large amount can point to signs of prostate cancer. However, the problem that occurs with the PSA test is that an elevated amount of PSA does not always mean someone has cancer.
“PSA does have limitations,” Dr. Salami says. “Sometimes you have elevated PSA in other conditions that are not cancer. PSA also typically can rise in benign conditions as we age. So you [can] end up in a situation where patients may have elevated PSA where they do not have cancer.”
That being said, just because the PSA test is flawed does not mean you should skip prostate cancer screening. Prostate cancer is the most common cancer in men, and multiple factors including age, race, family history, and genetics are associated with the disease. That’s why it’s important to utilize any screening tool which may be able to help you detect signs of the cancer early. The earlier stage the cancer is caught, the more treatment options you’ll have as a patient.
“We know in randomized trials that screening for prostate cancer is the best thing you can do to reduce your risk of dying from prostate cancer,” Dr. Freedland says. “It works.”