Prostate cancer is sometimes an elusive disease, even for experienced doctors. Despite having several screening options, we are not always sure about the diagnosis.
A prostate biopsy is the best way to make sure a patient has cancer. It would be the best was it not for the potential consequences and side effects.
For many years, urologists and other specialists have looked for alternative screening methods. We do have several options, but none of them is 100% accurate.
But according to a recent study, the answer may be simpler than expected. Researchers say that a specialized sugar test can help us screen prostate cancer. Why is it so important? And what is the science behind this novel prostate cancer test?
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Prostate cancer screening options
Prostate cancer screening is not currently handled similar to screening for other diseases. There are screening options, but they are not systematically recommended for all patients. Let’s take a quick look at the most important tests. As we do, you will find out why this is the case.
To screen prostate cancer, doctors typically use one of the following or a combination (1):
- Digital rectal exam: In this procedure, doctors insert a lubricated and gloved finger into the rectum. They feel the prostate gland looking for hard bumps. It is very useful because most prostate cancers are located in this area of the gland. The exam is useful but can be very uncomfortable. Moreover, results depend on the doctor’s experience and the location of cancer. Thus, it is important for diagnosis but never completely accurate.
- PSA level: PSA is a protein made in the prostate gland. It is typically limited to the seminal fluid, but a small amount leaks to the blood. A higher PSA in the blood usually relates to a bigger prostate. However, many factors can alter PSA levels, and it increases as we age.
- Prostate biopsy: It’s the only way to know for sure if someone has prostate cancer. But a prostate biopsy has many side effects and consequences. Patients may end up with continuous bleeding. Others have long-term pain symptoms as a result of a prostate biopsy. Thus, it is not recommended unless we suspect an aggressive cancer.
Controversy surrounding the PSA test
Out of many blood markers, the PSA is apparently the best. But there is much controversy regarding the PSA prostate cancer test. Some patients have a very high PSA, and doctors decide to perform a biopsy. The result shows no cancer cells, and the patient ends up with chronic bleeding. Or you have the opposite side. Some patients do not have a very high PSA but develop aggressive prostate cancer all of a sudden.
Thus, health authorities have said that it is not clear if screening for prostate cancer outweighs the risks. We can have misleading results and reduce the quality of life of patients.
That’s why special PSA tests have been formulated in an attempt to overcome this problem. We have tests such as the complexed PSA, the percent-free PSA, and other tests that combine different PSA measures such as the 4Kscore test, and the Prostate Health Index (2,3).
Still, we can’t be 100% sure about the diagnosis before a prostate biopsy. Is there any way we can increase the accuracy of these screening tests? According to a new study performed at the University of Birmingham, a specialized sugar test can be the key.
Sugar test: The key to a more accurate diagnosis?
There are different types of sugar, some of them more complex than others. When they are termed complex sugar or complex carbohydrates, they have several sugar molecules attached in a branched-chain. Glycans are one of these complex carbohydrates, and they come in many forms. They also become attached to PSA molecules.
Around 56 types of glycans can attach to PSA molecules. Each one has a different structure we can study in the lab. Only 4 glycan types out of 56 can be found in patients with cancer. We knew that before but didn’t have the technology to detect these glycans in PSA.
What the research says
The research team, led by Professor Paula Mendes, developed a new technique to identify these glycans (4). This way, we will not only be able to detect the PSA level. We can actually detect whether or not these PSA levels are likely related to cancer.
This technology uses a sort of receptor that only binds to the target glycan. It is great news for the medical community and may potentially reduce the number of false positives.
The University of Birmingham Enterprise patents the new method, and we can see the results of the investigation in the journal Advanced Function Materials. But before we get excited about having a new screening method, we should first understand how it applies to the clinical setting.
Later this year, the researchers in the team led by Professor Paula Mendes expect to apply this technology to actual patients and see how predictive it really is. It will only become available to the general public if they demonstrate a clear advantage over the already established screening methods discussed above.
This is an encouraging advance in the diagnosis of prostate cancer in the middle of the current pandemic with the coronavirus. Due to the current situation, Prostate Cancer UK, and other prestigious entities and individuals are encouraging donations to help to fund this type of research in times of crisis.
Conclusion
A test or screening methods for prostate cancer are still not accurate enough to offer patients a reliable diagnosis before prostate biopsy. Different PSA markers and scores have been developed over the years to save patients from the side effects of a biopsy procedure.
The most recent advance in this field is a new sugar test that detects a very specific glycan. It is a complex sugar that attaches to PSA and can be detected in patients with prostate cancer.
More research is needed to apply this new technology to the clinical setting and evaluate whether it provides more accurate results compared to the standard tests and methods.
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