New Urine Test Could Potentially Help Doctors Spot More Aggressive Prostate Cancers (Ishraq Ahmed Hashmi)

A new study published in JAMA Oncology has introduced the My Prostate Score 2.0 (MPS2) urine test. This test looks for 18 specific genes linked to aggressive prostate cancers, which are the ones that are more likely to spread quickly and be dangerous.

Just like with any other kind of cancer, prostate cancer is given a grade from one to five based on how quickly it's likely to grow and spread.2 The MPS2 test could help doctors identify prostate cancers that fall into grade groups two or higher, which are the ones we really need to watch out for.

Being able to tell the difference between high- and low-grade prostate cancers would be really helpful for doctors. If someone has low-grade prostate cancer, it probably isn't as much of a concern, so the MPS2 test could help rule out cases that don't need to be biopsied right away. This would be great news because biopsies can sometimes be painful, cause bleeding, and even lead to serious infections.

Mark Katz, MD, a clinical associate professor of urology at the Boston University Chobanian and Avedisian School of Medicine, thinks that being able to reduce the number of unnecessary biopsies would be a really good thing. He says it would mean less discomfort and risk for patients.

Beyond just the physical, the MPS2 test could also help ease some men's minds who have low-grade prostate cancer. They might worry less about unnecessary doctor's visits, tests, and procedures. This is especially true for those who might have felt like they were dealing with unnecessary anxiety.

Here's what experts had to say about the new test and how it compares to other prostate cancer testing methods:

How Does the MPS2 Exam Work?

The MPS2 test is an improvement on an earlier version, MPS, which came out about ten years ago. The research team behind it, based at the University of Michigan, created both tests. The original MPS test looked at two different genes linked to prostate cancer and a person's prostate-specific antigen (PSA) levels. Doctors have used the PSA test to screen for prostate cancer for decades.

But MPS2 is better than the original because it does a better job of detecting high-grade prostate cancer, says Arul Chinnaiyan, one of the study's authors. He's the director of the Michigan Center for Translational Pathology at the University of Michigan Medical School.

"MPS—the first version—and some other commercial tests for prostate cancer can find all types of prostate cancer, but they're not as good at finding high-grade, serious cancer in people with low-grade, less serious disease," he explained. "But MPS2 is better at finding that high-grade cancer."

The researchers behind MPS2 looked at urine samples from men who had elevated PSA levels or other abnormal findings during a rectal exam. They used data from a group of 761 men, with an average age of 63, to pick out 18 specific genes that might be linked to more serious types of prostate cancer. Then they tested a second group of 743 men using the 18-gene test and found that it was better at spotting the high-grade cancers that need treatment.

So, basically, MPS2 is like a supercharged version of its predecessor that can more easily tell the difference between high- and low-risk prostate cancers, which could be really helpful for men dealing with the disease.

“Across a whole bunch of patients, this new test stops about 40% of unnecessary biopsies. And it's especially helpful for those who've already had a negative biopsy, cutting down on the needless procedures by up to 50% in that group.

In real life, this means doctors can make better decisions about whether or not a patient with high PSA levels really needs further testing. Katz says that when patients and docs are faced with an elevated PSA test, they're usually stuck between a rock and a hard place trying to decide what tests to do next. This new urine test is supposed to help them figure out who might need more testing and who can probably skip it.

Prostate cancer is caused by a bunch of different things, but we're not totally sure what they all are. And MPS2 is just one of several tests that researchers are working on to figure it out. Compared to other tests, like MRIs and PSA blood tests, it's supposed to be a lot less expensive and easier to do.

So if you're a guy with an elevated PSA level, don't panic yet. There are lots of tests and treatments out there, and doctors are working hard to find the best ways to help you stay healthy. Just talk to your doc about what options are best for you, and don't be afraid to ask questions along the way."

Digital Rectal Exams Can Miss Prostate Cancer, Study Says

More Research Is Needed to Make Sure It's Accurate. This study's findings are promising, but there's still a lot we don't know.

For one thing, there weren't many people of color in the group they studied, and the researchers aren't sure if the results would be different for Black Americans.

That's important because Black and white men with prostate cancer can be really different. Black men often find cancer at an earlier stage and have more aggressive cancers. They also have a higher death rate from it.

The new test they're talking about, called MPS2, looks at 18 different biomarkers, which might help with these differences. But right now, there's no data to show that it works well for everyone. The researchers plan to study this more in the future.

Another question is whether the test works the same way for people of all ethnicities. We just don't know that yet.

The test is available now, but it's not super common yet. You'd have to ask your doctor to order it, and not all clinics can do that. But the researchers are working on making it more accessible.

Overall, this study is a step in the right direction, but we still have a long way to go before we really understand how best to detect and treat prostate cancer.