Cancer detection becomes better and better with earlier detection comes faster treatment and better results... The reliance on PSA testing for detection is becoming outdated as these 2 methods above will discuss. First, a Cell free DNA test for urine that can detect cancers. Earlier detection results in less biopsies and decreased mortality...
Second, cancer detection dogs have been able to sniff out prostate cancer with a high degree of sensitivity, but it takes time for training the dog, and the dog has a limited life span. What if a small device could possibly be as sensitive as a dog in identifying prostate cancer?? MIT is at an early stage for development of the device but this looks good for the future. A large clinical trial will be needed but men could start getting this additional testing while under surveillance to speed up confirmation for treatment. The article below:
You are most welcome.... always before, men got a PSA and if elevated, then you were watched or given antibiotics for a possible prostatitis and delays in treatment occur. These may speed up the process significantly and earlier detection is better... detection while PCa is inside the prostate is lives saved...
Dave, thank you for your very informative post…as usual.
In relation to the very important issue of early diagnosis that you have raised, an article in February’s issue of Urology Times presents an historical example of the harm that can be done by delaying diagnosis.
The article explores a study undertaken to examine the connection between the increased incidence of men presenting with metastatic cancer at diagnosis and a reduction in PSA screening in the USA over the last ten or so years. An issue previously explored by a number of similar studies.
Basically, the evidence presented at the 2021 Genitourinary Cancers Symposium further confirmed the previous studies... that the reduction in PSA screening is likely responsible for the rise in cases of metastatic prostate cancer presenting at diagnosis in the US. Probably not an unexpected outcome even to the non-scientific community.
So ultimately anything that improves early detection will be a great addition to the PC arsenal that is available now and will help men who have this condition access the very best and most appropriate intervention available.
Thanks for the reply.... interesting article.... why the decrease in testing is unknown to me...the fact that a simple urinalysis passed under a device can give highly accurate diagnosis of PCa is good news....as this develops, will cell phones have an app for Pca testing in the next 10 years?? Maybe... bodes well for guys like my sons...
And maybe my son with both a father and grandfather affected and son in law whose father has PC. Also 5 grandsons who have both maternal and paternal grandfathers with PC....sounds to me like those easy, more sophisticated tests you write about can't come soon enough.
In relation to the article... others would be more familiar with the background to the reduction in testing and have an opinion on whether it was based on financial savings or genuine concern about excessive treatment for low risk PC. Regardless of the rationale, probably not wise policy advice.
Basically, PSA screening was considered 'controversial' and the reduction in 2010 was based on the publication of the USPSTF Guidelines. As well as PSA tests, biopsies also decreased and the age group most affected were patients aged 55-69. There is a very interesting article 'Prostate Cancer Screening Trends After United States Preventative Services Task Force Guidelines in an Underserved Population' at ncbi.nlm.nih.gov/pmc/articl...
I think it's always useful to look back at what happened in the past so mistakes are acknowledged that probably have impacted severely on many men, especially those who for whatever reason were not able to seek information for themselves and now pay the price with metastases that might have been avoided or delayed. Thankfully, not all countries followed the trend of the US. Here, PSA's and biopsies at the first sign of trouble are SOC and actively promoted.
I think it is good that Oz followed their own path at that time. Not dissimilar to CoVid 19 paths chosen differently....I think that tests like these can help men with a family history catch PCa way before the need for biopsy and at earlier rises in PSA... reducing the number of deaths dramatically and the need for ADT... ADT is hard on the mind and body and relationships... Here's hoping for earlier detection in the future....Thanks for the reply...
Good post, Fish. It now seems that Dr. Greger's K9 "Pet Scan" is going HiTech. Even the poor dogs are getting replaced by technology.
Question for you: Will a urine test be usable for those who have had their prostate removed and are now testing for "undetectable" serum levels of PSA?
Interesting question....for someone like Gourd Dancer or yourself, would this be a fairly definitive proof of a cure?? For those undergoing RP, would something like this indicate treatment is needed or not even earlier than the follow up PSA?? I believe yes in both cases... Watch for the clinical trial and be a participant possibly.??..Just my 2 cents...
Well, I was actually thinking the opposite, because:
1. I had such a high PSA (25+ sans prostate) before I went on my brief, but effective 3-mo ADT treatment.
2. So, there was VERY high probability for lots of CTCs.
3. Therefore, only a serum test would be able to confirm the presence or absence of "active" PCa.
With my simple-minded understanding of the metabolic functions involved, it would seem that a serum lab would be "closer to the source" than would a urine lab.
I can not say you are wrong... without a CTC count done then one can not be sure how many CTC's were there before treatment... ADT kills CTC's by starving them of androgens they need to survive/thrive... I think the tests I discussed could detect CTC's because it is based on pieces of CfDNA, but would it be as accurate as a serum test?? Too early to tell I think... What everyone in the "Undetectables" wants to be able to do is "Just drop in"-and see what condition my condition was in...
This may be a part of the plan since serum CTC counts are muy costoso... and if this could be developed into a phone app...dang...that's a game changer... For me, I had a serum CfDNA test in August after undergoing ADT, Abiraterone/Prednisone and SBRT from prior November with 50 microgams detected of CfDNA that was not related to PCa... I think that bodes well for me and my vacation...
Without serial CTC counts, I can not know what the beast is up to, but sometimes, when on vacation, you can just not know and that is OK.... Just enjoying the break and feeling "normal" or like before... maybe I was Ab Normal.... maybe I am still Ab Normal...
I think that people who are nonmetastatic or oligometastatic can benefit the most from a test like this when "undetectable" on PSA. Another amigo, Fanger1, does the Biocept CTC test and it is not cheap without insurance. I believe in these stages that tumor/disease evolution is slow because there are limited tumor sites exchanging mRNA to make the disease stronger and speed disease evolution. That is why hitting it hard early makes all the difference IMHO...
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