Researchers at the University of East Anglia and the Norfolk and Norwich University Hospital have developed a urine test, dubbed 'PUR' (Prostate Urine Risk), to diagnose aggressive prostate cancer and predict whether patients will require treatment up to five years earlier than standard clinical methods.
The revolutionary test also identifies men who are up to eight times less likely to need treatment within five years of diagnosis.
The University says that it hopes the breakthrough “could help large numbers of men avoid an unnecessary initial biopsy and repeated invasive follow-ups for 'low risk' patients on active surveillance.”
Previous urine biomarker tests have been designed specifically for single purposes such as the detection of prostate cancer on re-biopsy (PCA3 test). But, this new test uses four PUR signatures to provide a simultaneous assessment of non-cancerous tissue and risk groups (low, intermediate and high-risk) to show how aggressive the cancer is.
Lead author Shea Connell from UEA’s Norwich Medical School, explained that “Prostate cancer is more commonly a disease men die with rather than from. Unfortunately, we currently lack the ability to tell which men diagnosed with prostate cancer will need radical treatment and which men will not.
“Current practice assesses a patient’s disease using a PSA blood test, prostate biopsy and MRI. But up to 75% of men with a raised PSA level are negative for prostate cancer on biopsy. Meanwhile 15% of patients who do not have a raised PSA are found to have prostate cancer – with a further 15% of these cancers being aggressive.
“A policy of ‘active surveillance’ has been developed as a way to combat this uncertainty, but it requires invasive follow-ups and constant reminders that a patient has a cancer with an uncertain natural history.”
“This results in up to 50% of men on active surveillance self-electing for treatment - whether they need it or not. It’s clear that there is a considerable need for additional, more accurate, tests.”
Prostate cancer is the most common cancer in men in the UK. It usually develops slowly and the majority of cancers will not require treatment in a man’s lifetime. However, doctors struggle to predict which tumours will become aggressive, making it hard to decide on treatment for many men.