Scientists have developed a new urine test that could make life much easier for men living with low-risk prostate cancer.
According to a new study, the test may help many patients avoid painful and invasive prostate biopsies while still allowing doctors to find cancers that become more dangerous over time.
The research was published in The Journal of Urology and involved more than 300 men who were being monitored for low-risk prostate cancer.
Prostate cancer affects millions of men around the world, especially older adults. In many people, the cancer grows very slowly. Some men may live for decades without the cancer causing serious problems. Because of this, doctors often choose careful monitoring instead of immediate treatment.
This monitoring strategy is called active surveillance. Rather than removing the prostate or using radiation immediately, doctors regularly check the cancer to make sure it is not becoming aggressive.
Active surveillance helps many men avoid major side effects from treatment. Surgery and radiation can sometimes lead to urinary leakage, sexual difficulties, and bowel problems. For low-risk cancers, doctors often believe close monitoring is safer than immediate treatment.
But active surveillance also has drawbacks. Patients usually need repeat biopsies every two or three years. A prostate biopsy involves inserting needles into the prostate gland to remove tissue samples for testing.
Although biopsies are common medical procedures, many patients find them stressful and unpleasant. Some men experience bleeding, infection, pain, or anxiety before and after the procedure.
Doctors currently use PSA blood tests and MRI scans to help decide when a biopsy is needed. PSA stands for prostate-specific antigen, a protein made by the prostate gland. High PSA levels can sometimes suggest cancer is becoming worse.
However, PSA tests are not always accurate because many non-cancer conditions can also raise PSA levels. MRI scans can provide useful images of the prostate, but they do not always clearly identify dangerous cancers either.
Researchers hoped the new urine test could improve this situation. The test, called MyProstateScore 2.0-Active Surveillance, looks for specific genetic signals in urine that are linked to more aggressive prostate cancer.
The study focused on men whose cancers were originally considered low-risk. These men had cancers classified as Grade Group 1, which usually grow slowly and are less likely to spread quickly.
Researchers found that the urine test was extremely good at identifying men who did not have dangerous cancer progression. If a patient received a negative test result, there was only about a 1% chance that a higher-grade cancer would be found on biopsy.
This level of accuracy gave doctors confidence that many men with negative results could safely skip repeat biopsies.
The researchers estimated that using the test could reduce unnecessary biopsies by as much as 64%. This could spare many patients from physical discomfort, emotional stress, and possible complications.
Dr. Jeffrey Tosoian, one of the study’s lead researchers at Vanderbilt Health, said the findings suggest the urine test may become a valuable tool for monitoring low-risk prostate cancer.
He explained that current monitoring methods often force patients to undergo invasive procedures because doctors lack highly accurate noninvasive tools. The new urine test may help change that.
The study also highlights how cancer care is becoming more personalized. In the past, many patients received similar treatments and testing schedules regardless of individual risk. Today, researchers are trying to design tools that better match each patient’s actual cancer behavior.
The grading system used for prostate cancer helps doctors estimate how aggressive a tumor may be. The Gleason score and Grade Group systems measure how abnormal cancer cells look under a microscope. Higher-grade cancers are more likely to grow quickly and spread to other parts of the body.
One major goal of active surveillance is finding the small number of patients whose cancers later become more aggressive while avoiding unnecessary treatment for everyone else.
Researchers say the urine test performed especially well at identifying Grade Group 3 or higher cancers, which are considered more serious and more likely to require treatment.
The findings may also improve quality of life for patients. Many men on active surveillance live with ongoing worry about cancer progression and repeat biopsies. A simple urine test may help reduce some of that anxiety while still keeping patients safe.
At the same time, scientists caution that more research is still needed before the test becomes part of routine care everywhere. Larger studies involving different populations will help confirm the findings.
Researchers are also interested in using similar testing methods in other parts of prostate cancer care. Future studies may explore whether urine-based tests can help detect cancer recurrence after surgery or radiation treatment.
The study represents another example of how modern cancer care is moving toward less invasive and more patient-friendly approaches. Instead of relying heavily on repeated tissue biopsies, doctors may increasingly use advanced urine, blood, or genetic tests to guide treatment decisions.
The researchers believe the new urine test could become an important step toward safer and smarter prostate cancer monitoring in the future.
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The study was published in The Journal of Urology.
Source: Vanderbilt University.
