Home urine test could 'revolutionise' prostate cancer diagnosis

[tallguy2]

Could the Brits be onto something...the end of DRE's?

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Home urine test could 'revolutionise' prostate cancer diagnosis

The 'PUR' test, pioneered by British scientists, detects chemicals in urine

Carrying it out at home with the first urination of the day is more accurate

It would also mean tests like rectal examinations could be avoided

And those on the 'watch and wait' list won't require so many follow ups

PUR can predict whether patients will require treatment up to five years sooner

A home urine test could 'revolutionise' prostate cancer diagnosis for thousands of men, British scientists say.

The 'PUR' test, pioneered by University of East Anglia and the Norfolk and Norwich University Hospital, detects chemicals in the urine secreted by cancer.

Being able to do a home test kit is a step forward because it could spell the end of uncomfortable rectal exams.

The urine test is also more accurate at home than the clinic because the first urination in the morning provides more clues than the rest of the day.

Men are on a 'watch and wait' list wouldn't require so many follow-up appointments if they could post a home-test kit, either.

PUR can predict whether patients will require treatment up to five years sooner than standard clinical methods, the scientists say, and assess how aggressive the disease is.

Lead researcher Dr Jeremy Clark, from UEA's Norwich Medical School, said: 'Being able to simply provide a urine sample at home and post a sample off for analysis could really revolutionise diagnosis.

'It means that men would not have to undergo a digital rectal examination, so it would be much less stressful and should result in a lot more patients being tested.

'The PUR test looks at gene expression in urine samples and provides vital information about whether a cancer is aggressive or 'low risk'.'

As part of a small study, the researchers gave 14 men at-home collection kits.

They then compared the results of their morning-time home urine samples with samples collected after a digital rectal examination.

WHAT ARE THE CURRENT METHODS FOR SPOTTING PROSTATE CANCER?

There's no single, definitive test for prostate cancer. A GP will discuss the pros and cons of the various tests with a man with symptoms to try to avoid unnecessary anxiety.

The doctor is likely to:

ask for a urine sample to check for infection

take a blood sample to test levels of prostate-specific antigen (PSA) – called PSA testing

examine the prostate by inserting a gloved finger into the bottom – called digital rectal examination

.

The GP will assess the risk of having prostate cancer based on a number of factors, including the patient's PSA levels and the results of their prostate examination, as well as their age, family history and ethnic group.

If the man is deemed at risk, they will be referred to hospital to discuss the options of further tests, which include an MRI and biopsy.

Source:

Dr Clark said: 'We found that the urine samples taken at home showed the biomarkers for prostate cancer much more clearly than after a rectal examination.

'Because the prostate is constantly secreting, the collection of urine from men's first urination of the day means that the biomarker levels from the prostate are much higher and more consistent, so this is a great improvement.

'And feedback from the participants showed the at home test was preferable.'

The most commonly used tests for prostate cancer include blood tests, a physical examination known as a digital rectal examination (DRE), an MRI scan or a biopsy.

Prostate cancer usually develops slowly and the majority of cancers will not require treatment in a man's lifetime.

Active surveillance, or 'watchful waiting' is a way of monitoring prostate cancer that isn't causing any symptoms or problems over the long term.

If these men could take an at-home test, they would only be called in if the results were concerning, instead of annually for painful and expensive biopsies.

Dr Clark said: 'The PUR test accurately predicts aggressive prostate cancer, and predicts whether patients will require treatment up to five years earlier than standard clinical methods.

'It means that a negative test could enable men to only be retested every two to three years, relieving stress to the patient and reducing hospital workload.'

Robert Mills, Consultant Surgeon in Urology at the Norfolk and Norwich University Hospital, said PUR is 'a very exciting development'.

'When we do diagnose prostate cancer, the urine test has the potential to differentiate those who need to have treatment from those who do not need treatment, which would be invaluable,' he said.

'These patients go on to an active surveillance programme following the diagnosis which may involve repeat biopsies and MRI scans which is quite intrusive.

'This urine test has the potential to tell us whether we needed to intervene with these patients.'

Independent academics were wary the latest findings, published in BioTechniques, were 'overstated'.

Dr Mangesh Thorat, deputy director of the Cancer Prevention Trials Unit at King's College London, said: 'They found that "at-home" samples are at least as good as samples in the clinic.

'However, these urine-based biomarkers, although promising and an area of active research, are not yet recommended for prostate cancer screening or during management of prostate cancer by active surveillance.

'Therefore, these findings do not currently have any clinical or public health implications. Should any of these biomarkers become a standard screening or surveillance tool in future, this new "at-home" method will be useful.”

Prof Justin Stebbing, Professor of Cancer Medicine and Medical Oncology, Imperial College, said: 'A test that can replace a hospital or doctor-based examination is important, but this study is too small right now to draw any conclusions.'

There is no national prostate screening programme as for years the tests have been too inaccurate.

Men over 50 are eligible for a 'PSA' blood test which gives doctors a rough idea of whether a patient is at risk. But it is unreliable.

Simon Grieveson, head of research funding at Prostate Cancer UK, said: 'We urgently need better tests both to detect prostate cancer early, and to help inform whether men are likely to need urgent treatment or if they can safely remain under active surveillance.

'This new test is early in its development, but has the potential to offer a simple, non-invasive way of predicting aggressive prostate cancer without the need for men to attend a clinic.

'Prostate Cancer UK and Movember are happy to announce that we have awarded funding to the team at the University of East Anglia to test this in a much larger group of men.'

Prostate cancer is the most common cancer in men in the UK, affecting around 47,000 men each year.

Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks.

[Murph256]

Yes, in this day and age of advanced medicine, it always puzzled me that I had to drop trou and bend over for every urologist and his assistant that I ever spoke to. I mean talk about midevil... And they always seem to do it just a little too eagerly. And what are they going to tell me that I don’t already know? I mean my PSA was at 11, quickly rising to 14. Give me the darned MRI already. The multiple DREs were one of the more unpleasant aspects of my treatments over the last two years.

Thank God for the Brits...

[GeorgesCalvez]

Hi there,

This could be quite an improvement as the current testing for PSA and DRE followed by biopsy and maybe MRE is not that specific or effective.

Without doubt there are a substantial number of men that could remain on active surveillance but instead are put through RP or radiation by over eager urologists.

There are also men who have the most deadly forms of prostate cancer that do not result in a rapid rise in PSA and start to metastase before they are detectable by DRE.

[Currumpaw]

Hey tallguy2!

Several years ago dogs were trained to detect prostate cancer with an almost perfect detection rate!

This test may partly be a result of how the dogs were able to smell prostate cancer. There are YouTube videos showing the dogs at "work".

Currumpaw

[TFBUNDY in reply to Currumpaw]

That's nothing. My ex wife could smell a 5 pound note at ten paces..

[jmurgia]

For a guy suffering from nocturia, which is the first urine of the day if you're up three to six times a night to urinate?

Joe

[Sxrxrnr1 in reply to jmurgia]

Could be overactive bladder caused by ingestion of spicy or acidic foodstuffs irritation of its lining.

Wine, any peppers, vinegar, citrus, wasabi, grapes,,,,,unfortunately the list is very long. Elimination of all such from diet for a few days may offer relief and a clue.

Urologist are notorious for suggesting it is BPH in men as cause, followed by medieval TURP in some manner,,only one guess as to why they must investigate further in women.

[Nelcar]

Thank you for the news about urine tests. Is there any way to contact such clinic/doctors/researchers?

[tallguy2 in reply to Nelcar]

Unknown. Please search for the Brits who published this.

[j-o-h-n]

That's old news..... Self Urine test is being replaced by self DRE............

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/01/2019 9:54 PM EST