Despite the volume of prostate cancer tests and treatments, experts and their patients are continually challenged to predict the disease's course and apply the most appropriate treatment. Now, two new diagnostic innovations – the PCA3 urine test and a more targeted prostate biopsy technique - could refine the way doctors diagnose prostate cancer and, subsequently, the way patients elect to treat it.
Current prostate cancer tests yield limited results. The prostate-specific antigen (PSA) blood test indicates the potential presence of prostate cancer, but it cannot predict disease type or aggression. The prostate biopsy confirms a prostate cancer diagnosis, but tissue retrieval is challenged by prostate gland size and placement and can result in missed tumors. Prostate cancer treatment expert, Dr. David Samadi , relies on both exams prior to recommending and performing his Samadi Modified Advanced Robotic Technique (SMART) prostate removal surgery, but agrees that testing could be enhanced. "Prostate cancer innovations like these will continually improve the life-saving benefits of early diagnosis and intervention," said Dr. Samadi.
What is PCA3?
PCA3, prostate cancer gene 3, is a gene-based urine test believed to more accurately predict the presence of prostate cancer and its future course. Unlike PSA level, PCA3 is not affected by other prostate conditions, such as benign prostatic hyperplasia (BPH), so results are more reliable.
"There are two viable applications for PCA3 scoring," explained Dr. Samadi. "If we learn that a man's PCA3 is elevated before biopsy, we can proceed with greater certainty of the biopsy's necessity. After biopsy, the test could help assess the urgency with which we treat the disease. Both applications could give greater peace of mind to men weighing treatment options, particularly robotic prostate removal surgery," he said.
More Targeted Prostate Biopsy
Researchers at the University of California Los Angeles (UCLA) published findings of an image-guided prostate biopsy study in this month's Journal of Urology, http://www.jurology.com/article/S0022-5347(12)04714-3/abstract. Attempting to produce more accurate biopsy results, they combined the imaging capabilities of MRI with ultrasound. Using this new prostate map, the biopsies performed under their study yielded a positive prostate cancer diagnosis in 53 percent of the 171 participants.
"Prostate biopsies can yield uncertain results," explains Dr. Samadi. "But using enhanced, overlaid imaging to more accurately collect prostate tissue is very similar to the robotically-enhanced visibility used during robotic surgery. This new, targeted approach mirrors the refinements afforded by the robot and could yield equally positive results."