According to a recent article published in The Journal of Urology, a protein referred to as EPCA could provide earlier detection for prostate cancer than the current standard PSA (prostate specific antigen) testing.
The prostate is a walnut-sized gland that is located between the bladder and rectum in males. It is responsible for producing components of semen. Prostate cancer is a very common malignancy in males, particularly older males, and screening efforts for this disease are widespread in the United States. Prostate specific antigens are proteins that are shed by the prostate and can be detected in a blood sample. An elevated PSA level is a sign of prostate cancer; however, elevated levels may also be a sign of non-cancerous conditions of the prostate. If a patient has an elevated PSA level, he will often get a biopsy, or tissue specimen, of the prostate. The specimen is analyzed through laboratory processes to determine if cancerous cells exist. Patients may have elevated PSA levels, negative biopsy results, and ultimately proceed to develop prostate cancer. This may be due to tissue specimens taken from areas of the prostate that are not cancerous and/or the pathologist does not accurately identify cells on the specimen as cancerous. Furthermore, the specific PSA level in which to detect the optimal number of prostate cancers without resulting in an overabundance of unnecessary biopsies has come under debate. Researchers are continuing to evaluate methods in which to more accurately detect prostate cancer in its early stages.
Researchers from the University of Pittsburgh recently conducted a clinical study to evaluate the protein EPCA as a potential marker for the early detection of prostate cancer. The researchers evaluated biopsy specimens for levels of EPCA in men who developed prostate cancer and men without prostate cancer (control group). The men who had prostate cancer had elevated PSA levels; however, initial biopsies were negative for cancer with subsequent biopsies revealing the presence of cancer. The researchers found that EPCA existed in 85% of biopsy specimens in the group of men that had prostate cancer, but was not present in specimens from the group of men that did not have cancer. EPCA was even found in biopsy specimens that were considered negative for cancer in the group of men who were later diagnosed with prostate cancer.
The researchers concluded that EPCA appears to be a very effective marker in detecting early prostate cancer. In this study, EPCA was even detected in biopsy specimens that were considered negative for cancer in men who were later diagnosed with prostate cancer. Larger clinical trials evaluating EPCA are warranted. Patients with elevated PSA levels or who are at a high risk of developing prostate cancer may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating EPCA or other diagnostic markers. Two sources of information regarding ongoing clinical trials include the National Cancer Institute ( cancer.gov) and www.cancerconsultants.com. Personalized clinical trial searches are also performed by cancerconsultants.com
Reference: Dhir R, Vietmeier BN, Arlotti J, et al. Early Identification of Individuals with Prostate Cancer in Negative Biopsies. Journal of Urology . 2004;171:1419-1423.
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