British scientists have identified a protein in urine that can help indicate which patients are at an increased risk of developing prostate cancer. The Cancer Research UK Cambridge Research Institute and The Institute of Cancer Research found that the level of MSMB protein in urine could provide a fast and accurate prostate cancer diagnosis for doctors and patients, potentially replacing the currently painful and more costly approach – a blood sample. Dr. David Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City believes this prostate cancer treatment discovery could be used to identify those high-risk patients that will most likely need a healthcare plan in fighting prostate cancer.
UK scientists discovered that the MSMB protein has a genetic link to prostate cancer. The MSMB protein levels are lower in the urine of men that have prostate cancer, which are also affected by the aggressiveness of the cancer. Previous research found genetic changes in patients with an elevated risk of developing prostate cancer. These genetic changes were present in a section of DNA that produces the MSMB protein. Patients at a high risk for prostate cancer produced lower levels of this protein.
"This discovery could greatly improve the accuracy of current prostate cancer screening methods for and could change the landscape for prostate cancer treatment programs," said Dr. Samadi, a robotic prostatectomy expert and urologic oncologist, "It is a step in the right direction towards a much-anticipated and highly-desired prostate cancer information method to identify men at an increased risk of developing the disease."
"In contrast to PSA levels, MSMB levels seem to be largely unaffected by an enlarged prostate," said Dr. Samadi. Critics believe the PSA test is too uncertain to be used in outlining prostate cancer treatment plans. The PSA test has a higher percentage of false positives in 10-15% of patients. Routine PSA screenings resulted in more than one million American men diagnosed with prostate cancer that they might otherwise have not died from.
Many more men undergo unnecessary prostate cancer surgery or radiation for prostate cancer, according to experts. "Men have PSA levels that differ naturally and that can sometimes be raised as a result of medical conditions, such as an enlarged prostate," said Dr. Samadi, "Alternately, some men with prostate cancer may not have a raised PSA." Dr. Samadi uses the PSA, digital rectal exam (DRE), Gleason scores, as well as family history and risk factors when determining how to go about treating prostate cancer in his patients.
"However, PSA testing is the best method we have at the moment for prostate cancer detection, although it has its limitations," said Dr. Samadi, "The discovery of new biomarkers such as this MSMB are important breakthroughs to expand prostate cancer screening and diagnosis." Prostate cancer is the second most common cause of cancer death of men in the United States. Over 217,000 new cases will be diagnosed this year; 32,000 men will die of it.
Dr. Samadi cautions that more research is needed before we can get too excited about the prostate cancer news. "Further research of a much larger study group will be needed to determine how effective the MSMB detection in the urine is for predicting the risk and aggressiveness of prostate cancer," he said.
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