Laura Crocitto, M.D., Research
Because of the lack of specificity of serum PSA new tests for the early detection of prostate cancer are needed. We are developing a new test that uses expressed prostatic secretions (EPS) collected after a prostatic massage performed at the time of the DRE. The EPS is then tested for the presence of telomerase. Telomeres are structures found on the end of human chromosomes. Telomeres are necessary for cells to divide normally. Part of the telomere is lost each time the cell divides, until eventually the telomere is so short that it can no longer function properly. At this point, the cell dies. Cancer cells have found a way to prevent the loss of the telomeres. They can produce a ribonucleoprotein complex with reverse transcriptase activity, which is called telomerase. This enzyme consists of 3 components, which can be detected in the lab. Telomerase activity has been detected in approximately 90% of prostate cancer tumor specimens. We can now detect telomerase activity, as well as the presence of the various telomerase components in the EPS. Our early results are encouraging, and indicate that this test may be better able to predict who has prostate cancer and therefore, to determine who should be advised to go on to a transrectal ultrasound and biopsy, and who can avoid this biopsy.