Could a new test really sniff out prostate cancer?

Researchers in England say a new diagnostic test shows promise in being able to detect urology-related cancers by “smelling” the diseases in urine samples.

The researchers said the new procedure could eliminate the need for the painful probes now given to older men as well as the prostate-specific antigen (PSA) exam, which has recently fallen out of favor.

"There is an urgent need to identify these cancers at an earlier stage when they are more treatable as the earlier a person is diagnosed the better,” said Dr. Chris Probert, a professor at the University of Liverpool’s Institute of Translational Medicine.

Dr. Eric Klein, a urologist at the Cleveland Clinic and chairman of the Glickman Urological and Kidney Institute, said “liquid biopsies” such as this urine test could be a standard treatment for all sorts of cancers in a decade or so.

“It isn’t as crazy as it sounds,” Klein told Healthline. “The test is based in science.”

The new urine test still must undergo medical clinical trials.

The study findings were published today in the Journal of Breath Research.

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Using Gas to Detect Cancer

In their study, Probert and his co-researchers worked in collaboration with the University of the West of England’s (UWE Bristol) Urological Institute at Southmead Hospital and Bristol Royal Infirmary.

The pilot group involved 155 men in urology clinics. Of this group, 58 had prostate cancer, 24 had bladder cancer, and 73 had urological problems without cancer.

The researchers used a gas chromatography (GC) sensor system called Odoreader that is able to identify different patterns of volatile compounds in the urine.

The researchers used algorithms and other advanced statistical methods to analyze urine samples. They said the Odoreader was able to detect the various cancers by synthesizing the compounds in the urine.

They said the prostate’s position close to the bladder gives urine a different algorithm if a patient has cancer.

“The results of the pilot study presented here indicate that the GC system is able to successfully identify patterns that allow classification of urine samples from patients with urological cancers,” the study authors wrote.

Klein explained that cancers produce distinct chemicals because of their specific biochemistry. These can be picked up under the right circumstances.

“If you use the right technology, you can detect these abnormal chemicals,” he said.

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The Benefits, Disadvantages

The English researchers said the new test could be used at patients’ bedsides, in doctors’ exam rooms, and at clinics.

They said it would provide quicker and more accurate results at an earlier stage of prostate and other urological cancers.

"There is currently no accurate test for prostate cancer, the vagaries of the PSA test indicators can sometimes result in unnecessary biopsies, resulting in psychological toll, risk of infection from the procedure, and even sometimes missing cancer cases,” said Norman Ratcliffe, PhD, a professor at UWE Bristol, in a statement. “Our aim is to create a test that avoids this procedure at initial diagnosis by detecting cancer in a non-invasive way by smelling the disease in men's urine.”

Other researchers on the study also expressed optimism.

"If this test succeeds at full medical trial it will revolutionize diagnostics. Even with detailed template biopsies there is a risk that we may fail to detect prostate cancer in some cases,” Raj Prasad, consultant urologist at Southmead Hospital, North Bristol NHS Trust, said in a statement.

Klein said these types of liquid biopsies can potentially be used wherever a liquid substance can be drawn from the body.

He said kidney cancer, bladder cancer, and even lung cancer could be candidates for such tests.

He added the prostate doesn’t create much urine, so an additional screening such as a rectal exam would probably be needed, along with a urine test, for prostate cancer detection.

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