A Novel Urine Test May Prevent Needless Biopsies in Men with Elevated PSA
You are familiar with the routine if you have ever received an abnormal PSA result: biopsy time. However, that next step proves to be both needless and intrusive for a lot of males. Researchers may now have discovered a more effective path forward, one that is much more accurate and less stressful.
The Reasons Biopsies Are not Always the Best Course of Action
The most reliable method for confirming prostate cancer is a prostate biopsy. However, it has drawbacks. In addition to causing bleeding, illness, and anxiety, the operation frequently reveals low-grade, slowly developing cancers that could never be a major concern. In other words, men are still being exposed to anxiety and the negative consequences of overdiagnosis even while we are identifying tumors that do not require immediate treatment.
Researchers and medical professionals have been looking for strategies to cut down on needless biopsies. Though access and interpretation can be challenging, particularly in smaller clinics or rural hospitals, tools like the Prostate Health Index (PHI) blood test and specialist MRI scans have been somewhat helpful.
The MPS2 Urine Test is now available.
The MyProstateScore 2.0 (MPS2), a urine test developed at the University of Michigan, is a game-changer that could help avoid the biopsy decision entirely. In contrast to PSA, which increases for a variety of reasons, not all of which are related to cancer, MPS2 looks for particular genetic cues associated with aggressive tumors.
According to the study's pathologist and urologist, Dr.
The Test's Construction
More than 58,000 genes linked to prostate cancer were initially discovered by researchers using publicly available databases. They focused on 54 genes that were overexpressed in higher-grade cancers (those classified as Grade Group 2 or higher, which entail increased risk) from that enormous pool. They next compared urine samples from 761 individuals with high PSA to those gene markers.
The outcome? The MPS2 test is based on a revised list of 18 genes that consistently indicate the presence of high-grade prostate cancer.
Researchers examined more than 800 urine samples from men in a nationwide prostate cancer collaboration to confirm their findings. The outcomes of the actual biopsy were then contrasted with the results.
What the Findings Illustrated
It was strikingly accurate. MPS2 found:
95% of malignancies in Grade Group 2
99 percent of malignancies were classified as Grade Group 3 or higher.
But that is not all. The test prevented 41% of needless biopsies when researchers took the prostate's volume into account (yes, size does matter). 37% of biopsies were still saved even without the volume adjustment. In contrast, just 26% of biopsies were averted by the PHI blood test.
Superior to MRI? Maybe. More Reachable? Definitely.
Though not always accessible or reliable, MRI scans, particularly the multiparametric type used for prostate screening, can be beneficial. Depending on the radiologist, results can differ, and not all hospitals have the necessary equipment or knowledge.
A urine-based test like MPS2 seems so promising for this reason, among others. It does not call for intricate interpretation or sophisticated imaging.
Not Only Correct, But Also Useful
Urologist Dr. Boris Gershman of Harvard-affiliated Beth Israel Deaconess Medical Center described the findings as "promising," but he said that putting the test into practice will bring up new issues. The MPS2 offers a continuous risk score ranging from 0% to 100%, in contrast to MRI scans that only provide a yes/no response. That subtlety can be both a strength and a weakness. When is it appropriate to recommend a biopsy, exactly?
Nonetheless, a lot of experts think this might be a significant turning point, particularly for men in neglected or rural areas.
Prostate cancer specialist Dr. Marc Garnick, a Harvard professor, stated simply: "A commonly accessible pee test may help us better distinguish who really needs a prostate biopsy—and who doesn't." That is true progress.
Important Lessons for Patients:
Do not panic if your PSA is high. Before undergoing a biopsy, MPS2 may provide a safer method of determining your risk.
Find out from your doctor if your clinic offers urine-based genetic testing.
Keep an eye on this area. MPS2 may soon change how we identify and treat prostate cancer as it becomes more accessible.
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