New Genetic Urology Tests for Prostate Cancer: New testing methodologies can detect potential concerns much earlier, says Dr. Phranq Tamburri
May 30, 2014 08:57AM
● By Dr. Phranq D. Tamburri
Prostate cancer is the most common cancer diagnosed in men today. It is currently exceptionally common given the aging boomer generation being tested using the prostate specific antigen (PSA) blood test, along with the growing incidence due to many false positives generated by the test. With waning confidence in PSA, conventional and naturopathic physicians have access to an exciting new genetic molecular urine test that has exceptional predictive value in determining whether a patient's prostate cancer is really a problem or not.
Studies have demonstrated that the majority of elevated PSA tests are elevated for reasons independent of prostate cancer. For example, such other causes are infection, inflammation, benign prostatic hyperplasia, bike riding, sex before the test or simply older age. This means that a positive PSA test may cause anxiety over a cancer that does not exist. Unfortunately, the only way to legally confirm whether there is cancer present is to undergo a displeasing rectal biopsy of the prostate that may or may not even hit the lesion. Many patients today are seeking an alternative method to determine their realistic prostate cancer risk.
The most significant over the past decade is the PCA-3 molecular marker test. Following a prostate exam, urine is collected that flushes messenger RNA specific for prostate cancer from the urethra and is sent to special urological laboratories. If a positive is found, then this suggests very strongly (with an accuracy of 70 percent) that prostate cancer will be identified on a biopsy. This result is not a legal diagnosis of cancer, but is very helpful for a patient to determine whether a biopsy is appropriate; that is, determining if the biopsy is in the patient's best interest or in the interest of the urologist that simply wants the biopsy to ensure liability protection. The PCA-3 test has only recently been approved by the U.S. Food and Drug Administration, and hence more available.
The prior problem was determining if prostate cancer is present especially if the blood PSA test was initially concerning. However, confirming prostate cancer is only half the problem, and concern for patients. This is because the majority of prostate cancer diagnosed upon random biopsy for a PSA between 2 to 10 has a mortality rate of less than 10 percent. This means that there is only a one out of 11 statistical chance of dying from prostate cancer, even after it has been diagnosed by a urologist. These odds can still be dubious to patients when they discover that the majority of prostate cancer surgeries lead to permanent urological damage such as incontinence and erectile dysfunction. Therefore, the second question patients will ask after diagnosis is, "Is my cancer an aggressive form that should be surgically removed, or will I likely die of something else, and thus can avoid surgery and instead follow natural treatments?"
Following the great success of the PCA-3 test, a sequel was just publicly released this year. It is a similar genetic urine test, but results in a value from an algorithm that determines the likelihood that a prostate cancer is aggressive. This is determined in the laboratory by testing for the amount of RNA cross-linking found in prostate cancer genetic material. The higher the cross-linking, the more likely a prostate cancer will be determined to have an elevated aggressiveness.
Although a third genetic molecular marker test is on the horizon, the first two have already been significantly empowering men with powerful assessment tools not available to the typical urology patient. This information can help them determine with their physician the best course of action—natural active surveillance or conventional treatments—when confronted with the current confusion of PSA testing and the omnipresent risk of prostate cancer.
Phranq D. Tamburri is a naturopathic physician specializing in men's health, with a sub-specialty in prostate cancer, at Longevity Medical Health Center, in Phoenix. For genetic testing, call 602-428-6151. For more information, visit LongevityMedical.com.