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via urine diagnosis
Hi.
Is it possible to obtain a diagnosis of prostate cancer using urine only? And not having to go through a biopsy?
Is it possible to obtain a diagnosis of prostate cancer using urine only? And not having to go through a biopsy?
Hi.
It is true that prostate cancers tend to involve bone. If there was a reason to evaluate the bones, such as pain – then a bone scan would be requested. In the absence of any pertinent symptoms, a hint is taken using the PSA level as a threshold of when a bone scan would be done.
There are folks who feel anxious when no test is done, but we’ll have to realize that these tests themselves are not perfect, not fool-proof. Even if you do all the tests for an unspecified population, accuracy of the results will be doubted. There are such things as false positive and false negative tests. Doing the tests indiscriminately therefore will not really relieve any anxiety. In general, the doctor must balance not just the capability of the tests to detect problems, but also, their applicability for a specific patient.
My best to you. Happy Holidays.
It is true that prostate cancers tend to involve bone. If there was a reason to evaluate the bones, such as pain – then a bone scan would be requested. In the absence of any pertinent symptoms, a hint is taken using the PSA level as a threshold of when a bone scan would be done.
There are folks who feel anxious when no test is done, but we’ll have to realize that these tests themselves are not perfect, not fool-proof. Even if you do all the tests for an unspecified population, accuracy of the results will be doubted. There are such things as false positive and false negative tests. Doing the tests indiscriminately therefore will not really relieve any anxiety. In general, the doctor must balance not just the capability of the tests to detect problems, but also, their applicability for a specific patient.
My best to you. Happy Holidays.
Hi.
Thank you for your very informative post.
I’ve been reading about prostate cancer and bone involvement, shouldn’t the evaluation also include an X-ray or something to see if bone is involved? Is there a unique blood test for this? My brother though doesn’t actually feel any pain, or so he says.
Thank you for your very informative post.
I’ve been reading about prostate cancer and bone involvement, shouldn’t the evaluation also include an X-ray or something to see if bone is involved? Is there a unique blood test for this? My brother though doesn’t actually feel any pain, or so he says.
Hi.
The urine may be able to slough off cancer cells that upon examination will be diagnosed, this is called urine cytology.
For prostate cancer, this would be very unusual (it generally does not invade the tube where urine passes without invading other areas), the urine cytology is more likely useful for cancers involving the urinary bladder and the ureters (tubes that connect the kidney to the bladder), though it may be able to catch about 40-60% of cases, a good number of cases will still need a scope (which would be invasive).
There are newer tests being developed that use biomarkers that can be obtained in urine to detect early prostate cancer. Some of these involve enzymes such as glutathione transferases. These biomarkers are still under development and are not available to make clinical decisions.
In general, early detection of prostate cancer involves a rectal examination by a doctor and PSA. There are controversies as to the benefit of screening per se, as screening for prostate has not shown similar trends of overall improvement unlike what has been observed for mammography and breast cancer. It is best that the decision to screen be made by both doctor and patient.
The urine may be able to slough off cancer cells that upon examination will be diagnosed, this is called urine cytology.
For prostate cancer, this would be very unusual (it generally does not invade the tube where urine passes without invading other areas), the urine cytology is more likely useful for cancers involving the urinary bladder and the ureters (tubes that connect the kidney to the bladder), though it may be able to catch about 40-60% of cases, a good number of cases will still need a scope (which would be invasive).
There are newer tests being developed that use biomarkers that can be obtained in urine to detect early prostate cancer. Some of these involve enzymes such as glutathione transferases. These biomarkers are still under development and are not available to make clinical decisions.
In general, early detection of prostate cancer involves a rectal examination by a doctor and PSA. There are controversies as to the benefit of screening per se, as screening for prostate has not shown similar trends of overall improvement unlike what has been observed for mammography and breast cancer. It is best that the decision to screen be made by both doctor and patient.
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