Accurately diagnosing prostate cancer is a challenge. Current screening methods using blood tests sometimes show abnormal results even when a man does not have cancer, leading to a biopsy, or normal results when he does.
UF Health Cancer Institute researchers wanted to measure compounds in urine to identify new biomarkers related to prostate cancer and other prostate health disorders. They’re developing a fast, noninvasive diagnostic test for patients. The method, described in a recent publication in the journal Analytical Chemistry, could help guide and personalize treatments for one of the world’s most deadly cancers.
About 1 in 8 men in the United States will be diagnosed with prostate cancer. It’s the second-leading cause of cancer death in American men. Prostate-specific antigen, or PSA, tests are commonly used to screen for prostate cancer by detecting high PSA levels in the blood.
However, PSA levels can be elevated by noncancerous conditions such as an enlarged prostate, prostatitis, urinary tract infections or even recent sexual activity. In addition, doctors still lack a single test that reliably separates life-threatening, aggressive cancer from the slow-growing version. That can lead to overtreatment of low-risk cancers.
“We need new screening technologies that can guide fast, efficient, patient-friendly and safe diagnosis and treatment options to manage aggressive disease,” said Timothy Garrett, Ph.D., an associate professor and chief of experimental pathology in the UF Department of Pathology, Immunology and Laboratory Medicine and the study’s senior author.
The new method uses a technique called paper spray. Researchers apply a urine sample from a specimen cup to paper in the shape of a triangle. Next, an electric current is run through the paper to create a spray, which causes metabolites to ionize. Metabolites are small molecules produced as a result of chemical processes in the body and can be biomarkers of disease.
Researchers then measure those ionized metabolites with a mass spectrometer. The process is quick: samples can be analyzed in less than 30 seconds. The test does not require a digital rectal exam, an advantage over some existing urine-based prostate tests.
“We are able to identify specific metabolites that allow for the clear diagnosis of prostate cancer from several prostate disorders such as enlargement or infection of the prostate gland,” Garrett said. “This means we can develop a rapid screen that combines the collection of urine, analysis on paper and identification of several prostate disorders from a single test.”
In the new study, Garrett’s team used the method to analyze samples from 40 people: healthy men, men with an enlarged prostate, men with prostatitis and men with prostate cancer.
They identified 37 significant features among the conditions, demonstrating the test’s ability to rapidly classify prostate health disorders.
“The test had strong predictive accuracy, showing its promise as a noninvasive diagnostic tool,” Garrett said. “Results from our pilot testing clearly distinguish prostate cancer from other prostatic disorders, improving diagnostic accuracy.”
Next, the team will work to develop a large-scale test that includes home-sampling approaches and remote collection in rural areas to make testing widely available.
Iqbal Mahmud, Ph.D., a postdoctoral associate in Garrett’s lab, is the first author of the study, which was supported by the UF Clinical & Translational Science Institute, which is supported in part by the National Center for Advancing Translational Sciences.
