Tuesday, November 04, 2014

The Urine Test

In a recent edition of the Otago Daily Times, there was a reprint of an essay Chris Harris wrote on the need to find a better method of detecting prostate cancer.

At present one of the prime methods used is a biopsy in which a needle is pushed up into the man's anus, and then through the wall dividing the bowel and the prostate. Tiny pieces of his prostate are chipped off and then sent to the lab for examination. This is the examination I had back in late 2008. There were complications as a result of this biopsy which I describe in some detail in my ebook, Diary of a Prostate Wimp. [This ebook is currently available at half-price at Smashwords to support Movember, the prostate cancer month.]

The problem with this biopsy - the transrectal method - is that infection can easily occur. In fact, men are routinely given antibiotics after the biopsy because it's assumed there will be infections. It's hardly surprising that there are, because the wall between two parts of the body - one of them intended to deal with faecal matter - is pierced and broken open. It's a bit like sticking your hand in a toilet, then using your hand straightaway to put food in your mouth. If you don't get infected, it'll be surprising.

Chris Harris wrote about a new option that's being looked at to avoid this biopsy. Currently several PSA blood tests are done before a biopsy is considered, in tandem with the unpleasant finger up the bum approach that shows whether the prostate is unduly enlarged or not. Chris says the PSA test was never designed to do what it's being used for now, and writes: 'We aim to take a more direct approach by analysing small amounts of prostate cells exfoliated in urine. There is evidence that very small amounts of prostate cancer cells, between one and a few dozen, are shed normally into the urine at an early stage of the disease. Our aim is to pick out these cancer cells and extract molecular information from them to predict if a tumour is going to become a malignant monster or a benign wimp.'

It's normal for men's prostates to enlarge as they get older. Most of the time this isn't anything to do with cancer; it's a common problem many men will have to deal with - as I did. Surgery is performed to decrease the size of the prostate, thus allowing the urinary tract to function properly. (The urinary tract gets blocked by the prostate rather like a large stone in a small river bed.)

There is hope that the urine test will be readily available soon - possibly within months. In the UK, trial tests of the urine samples were accurate in about 70% of cases. However Chris warns that there is still work to be done to ensure thorough accuracy. And of course, as always, funding is a problem.

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