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Real Health Black Men
This is a space where we talk about the things that matter to us. We're building a community dedicated to empowering Black men to take control of their health. We're bringing you vital information, cutting through the noise, and giving you the real deal on everything from major health issues to mental wellness, physical fitness, and everything in between. We know that real change happens with support, and that's exactly what we're here to provide.
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Real Health Black Men
Episode 4: Pee in a Cup, Save Your Life: The New Test That's Changing Prostate Cancer Screening - Dr. Jeff Tosoian
Dr. Jeff Tosoian reveals a groundbreaking advancement in prostate cancer detection that could save thousands of lives, especially among Black men who face double the risk of both diagnosis and death from this disease. The newly available My Prostate Score 2.0 (MPS2.0) test represents years of meticulous research aimed at solving one of medicine's most persistent challenges: accurately identifying dangerous prostate cancers while reducing unnecessary procedures.
Growing up with parents diagnosed with multiple cancers, including his father's unusually early prostate cancer diagnosis in his 40s, Dr. Teshoian's personal mission led him from laboratory research to developing practical solutions for patients. He explains how traditional PSA testing, while valuable, often results in unnecessary biopsies because it's prostate-specific but not cancer-specific. In fact, approximately 75% of prostate biopsies performed after elevated PSA readings alone come back negative.
The real innovation of the MPS2 test lies in its ability to detect 18 genetic markers specifically associated with aggressive prostate cancers - the kind that actually requires treatment. Through urine testing that can be completed at home, this breakthrough can prevent between one-third and one-half of unnecessary biopsies while still identifying 95% of dangerous cancers.
This episode offers hope through scientific advancement for listeners concerned about prostate health, particularly Black men at higher risk. The MPS2 test requires a doctor's prescription but provides a clear, actionable risk assessment without invasive procedures. Ask your doctor about MPS2 today—it might be the most important health decision you make this year.
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This is the Real Health Black Men podcast, where we empower men to take control of their health. We provide vital information and build community support. Join us as we discuss everything from major health challenges to mental wellness to physical fitness. So if you're ready to level up your health and your life, you're in the right place. Let's get started. So today, my guest on real health black Men is Dr Jeff Tesoyan. We met recently at a conference and he's becoming a quick friend. I was very impressed by him and the work that he's doing, so he agreed to come on our podcast and I'm sure that you, our listeners, will enjoy this presentation, that you, our listeners, will enjoy this presentation, as we talk about a new product that's coming to the market, but also some his research and some work that he's doing in urologic cancer research. So I'm excited to have Dr Tosoian on our program today. Welcome, dr Tosoian.
Dr. Jeff Tosoian:Thank you. Thanks so much, Grandley. It's a pleasure to be here.
Grantley Martelly:Thank you. So let's begin by introducing yourself. Tell us a little bit about you and your specialty, and how you got to where you are today.
Dr. Jeff Tosoian:Yeah, absolutely. So we can start from the beginning. I grew up outside of Detroit, of Detroit. My mom was a school teacher, dad was a carpet cleaner, and so really no one in my family was in the medical field. But strangely, from a young age I was very interested in medicine, and particularly in cancer. And so, as it turned out, over my childhood really from the ages of 10 to 16, my two parents were diagnosed with cancer three times, including prostate cancer in my dad in his 40s, which is quite young, and so I think, through that, the interest in cancer really became more of a mission, and by the time I went to college I was pretty dead set on having some type of impact against cancer.
Dr. Jeff Tosoian:So I went to college at the University of Michigan, majored in cellular and molecular biology and joined a lab studying the genetics of prostate cancer, and that was my first introduction to research. And I'll be honest, that time spent in the lab I, yes, certainly learned a lot, but it also, it felt a long way from helping patients, way from helping patients, and that was really what I was most eager to do. And so I did have some second thoughts about whether I thought research would be a part of my career, I moved to Baltimore for medical school, johns Hopkins, and toward the end of my first year I met a urologist focused in prostate cancer named Val Carter, and I remember learning about the research that he was doing and saying to him depending on what we find, this could really help patients tomorrow. To which he smiled and nodded, and so you know that had me really excited about research again, seeing that it could have that impact in the short term. And Bell was certainly a leader in the field.
Dr. Jeff Tosoian:He was one of the first to recognize that some prostate cancers don't need to be treated, of the first to recognize that some prostate cancers don't need to be treated but could instead be monitored on active surveillance. And he had set up that first program in the United States in which low-risk prostate cancers were closely monitored rather than treated. And over many years, and after enrolling thousands of patients, we published a series of papers showing that it was, in fact, safe to monitor certain patients with low-risk prostate cancer. And so now, in 2025 and for the last several years, active surveillance is considered the standard of care for low-risk prostate cancer. The other thing that Dr Carter did was, of course, with the patient's permission, collected blood and urine in our patients so we could find better ways to detect prostate cancer at an early curable stage. And that was something that interested me a great deal, because we know that the best way to reduce the harm caused by prostate cancer is to detect it early, before it has spread, at a stage where it's still curable. And so I learned a great deal from him and other mentors at Hopkins, and all in all, I spent 11 years in Baltimore between medical school and urology residency and a master's degree in public health.
Dr. Jeff Tosoian:After residency, I went back to Ann Arbor, michigan, for a fellowship in urologic cancers and translational cancer research, and I think I'll point out that when we say translational research, I think that's a term that a lot of us aren't real sure what that means all the time, and that's really referring to translating the work that's done in the laboratory into things that can be used clinically to actually help our patients, and so that's what's referred to by translational research, and, unlike my initial time in Ann Arbor as an undergrad, I now had a better understanding of what was needed in research and how I could use my training to that point as both a researcher and a clinician and surgeon to help fulfill that role, and so I started working with really one of the probably the world's most accomplished lab scientists there at the University of Michigan, arul Chanayan, and he was both a mentor and a partner in the work that we'll talk about today, which we started back in 2019.
Dr. Jeff Tosoian:And just to fast forward to today, and just to fast forward to today, I did, after many years, finally finish my training in 2021. And I joined the faculty here at Vanderbilt as the director of translational cancer research here in our department of urology. I'm also a clinician and surgeon, so I see patients here at Vanderbilt and also at the Nashville VA, and much of my practice is focused in the early detection and management of prostate cancer.
Grantley Martelly:I have a question about urologic cancers. Can you give us an idea of what are some of the things? When you refer to urologic cancers, what do you?
Dr. Jeff Tosoian:mean Absolutely, absolutely. My training is as a urologic oncologist, which means a cancer doctor within urology, and so that's referring to prostate cancer, bladder cancer, kidney cancer and testicular cancer. Those are the main urologic cancers on which our work is focused.
Grantley Martelly:This episode we're talking about mainly prostate cancer, but it's good to know that there are those other cancers that also affect men, and I assume that some of those cancers are also present in women as well. Is that true?
Dr. Jeff Tosoian:Kidney cancer and bladder cancer are a concern in women as well, though prostate and testicular are just for us men.
Grantley Martelly:Just for us men. Let's talk a little bit about the disparities in cancer, because one of the ways that we met was actually at a conference and at an organization that focuses on the disparities of prostate cancer, specifically in Black people and people of color, people of African descent. So can you shed some light on that?
Dr. Jeff Tosoian:Yes, we know. In the US, approximately one in six men will be diagnosed with prostate cancer throughout their lives, and we know that age is the greatest risk factor, right? Folks have probably heard the common sayings if you live long enough, almost all men will develop prostate cancer at some point and so those risks, however, are higher in black men.
Dr. Jeff Tosoian:Both the risk of being diagnosed with prostate cancer is about two times higher in black men and the risk of dying from prostate cancer is also approximately two times higher in black men, and so this is, of course, a point of great interest and a point of study in the field.
Dr. Jeff Tosoian:There have been some studies and this is an important point to make that there have been some studies that have shown, in healthcare systems where there is equal access to care so the VA, for example, where all vets receive the same access to care, much of the disparity in mortality and death from prostate cancer is eliminated has been shown to be non-existent in a number of studies where care received is equivalent. And so, absolutely first and foremost, this gets into the social determinants of health and how important it is to ensure that all patients have access to good quality healthcare. That's 1A, first and foremost. That being said, differences in access to care would not explain why black men are more likely to be diagnosed with prostate cancer, and, furthermore, we know that when we look at the actual tumors prostate cancer tumors in white men and black- men we do see differences in those tumors in terms of their genetic makeup.
Dr. Jeff Tosoian:Absolutely reducing disparities and achieving equity in healthcare needs to be at the top of everybody's list. That being said, there still are some differences between the races, particularly in terms of prostate cancer. That leads to some additional considerations as we look to reduce the harms of prostate cancer on our population and on all of us and our families.
Grantley Martelly:So you said the tumors look a little bit different. Could you give us a little bit more information on that from a layman's point of view?
Dr. Jeff Tosoian:that from a layman's point of view, yes, and that gets a little bit tricky and we'll find our way somewhat into the weeds. But we can think of it as in. There are different pathways at the level of the cell that can lead a cell to become cancerous through changes to its DNA or mutations, and we found that the changes that lead to cancer in white men and black men, well, largely there are instances in both races of given change, mutation A, leading to prostate cancer. The proportion of white men versus black men that have certain types of changes that lead to cancer differ between the races, between the races, and so if black men, for example, have mutation A, that leads to prostate cancer in 25% of the prostate cancers we find in black men there's one known mutation that accounts for 50%.
Dr. Jeff Tosoian:That same mutation, we'll call mutation A, accounts for 50% of the cancers in white men, and so there's ultimately it's the same pathways, but the frequency with which those pathways are seen does differ between the races.
Grantley Martelly:Now, does that mean that genetics of the black population and the white population are different?
Dr. Jeff Tosoian:It's an excellent question. It's an excellent question. The answer is and this is where it's very important to distinguish between our, you know, the genetics that drive who. We are right. Our DNA, which we now know, is not very different between black men and white men, and, and so that's called our, our germline DNA, that's the DNA that we have in, called our germline DNA. That's the DNA that we have in every one of our cells. By contrast, we're talking about the tumor itself, or the cancer itself. The term we often use for that is somatic S-O-M-A-T-I-C. The somatic genetics of the tumor itself is what differs by race.
Grantley Martelly:Thank you for that clarification, thank you for that explanation, and you mentioned access as one of the challenges, which we all know is important. There let's talk about early screening. Is early screening important in helping reduce the death rate?
Dr. Jeff Tosoian:Yes, absolutely.
Dr. Jeff Tosoian:That being said, this has been a point of a little bit of controversy over the last two or so decades when we talk about screening for prostate cancer, screening for early diagnosis that is initiated through a blood test called PSA.
Dr. Jeff Tosoian:That stands for prostate-specific antigen, and this is a protein that's made in the prostate and is detected with a simple blood test.
Dr. Jeff Tosoian:Like most tests, it has its pluses and minuses. The negatives of PSA is that, as the name implies, it is prostate-specific, so the distinguishing factor there is that it is not prostate cancer-specific is a blood test where the levels can be elevated for reasons other than prostate cancer, and so when we talk about PSA as a screening test for prostate cancer, it's sensitive for prostate cancer, which means that the majority of men with prostate cancer do have an elevated PSA level, but it is not specific for prostate cancer, and so that means that of men with an elevated PSA level, the majority of them actually do not have prostate cancer, because the PSA test can be elevated for many reasons, and so I think a good analogy I once heard is to think of it like the screening we do at the airport. They want us to go through the metal detector and what have you and what they are aiming for at that step is anything that possibly could be harmful sets that off and leads to additional testing.
Dr. Jeff Tosoian:In the case of the airport, leads to you know they come over with the wand and maybe give you a little pat down, and so they're essentially okay with the fact that there will be some false positives, some false cases in which the alarms go off when really that person doesn't have anything harmful.
Dr. Jeff Tosoian:Same sort of idea with the PSA test.
Dr. Jeff Tosoian:It will be elevated in the majority of men with prostate cancer, but it is also elevated in many men that do not have prostate cancer and, in fact, the majority of men with an elevated PSA.
Dr. Jeff Tosoian:If we were to biopsy all of those men, which was practiced 20, 30 years ago, we learn that the majority of those biopsies will be negative. And that's what the early studies showed was that if an elevated PSA level which that has been defined differently by different groups, but generally we can say that a PSA above three is considered moderately elevated, if we biopsy every man with a PSA above three, around 75% of those biopsies will be negative. And so this led to the US Preventative Services Task Force and other agencies that set guidelines for clinical practice to say, well, maybe PSA testing is not a good thing, and so that led to some recommendations against PSA testing back in 2012. Some recommendations against PSA testing back in 2012,. Those recommendations have since beenarker tests or like imaging tests that will help us to determine which of those men with an elevated PSA truly need to undergo a biopsy, those that are at higher risk of having a prostate cancer that could prove harmful, and which do not need to undergo a biopsy.
Grantley Martelly:I want to stress, though and I want to see if you agree with this that just because PSA test is not specific for prostate cancer, because prostate cancer has a higher propensity of occurring in black men, because prostate cancer has a higher propensity of occurring in black men.
Dr. Jeff Tosoian:We're not saying that early screening is not important, because it seems to me that it's even more important because there's a double likelihood. Yes, yes, and many, many would agree with that. I think I would consider myself one of them. Right, early screening and detection of these cancers, while they remain localized to the prostate at a point where they can be cured, really is essential.
Dr. Jeff Tosoian:Opposite side of that, or I guess I would say, with the caveat that, you know, screening and a, an evaluation for for a given patient needs to be done thoughtfully. It needs to be performed in in men who have a a life expectancy of at least 10 years, which for men of average health goes into the 70s. But there is an age beyond which screening is no longer advisable and you know, like with all things, testing is, it's that balance of of risk versus benefit. My opinion is that the the benefit of early detection does far outweigh the the risks of of screening, as long as that screening is done responsibly, as long as we're not using that 1990s pathway in which an elevated PSA automatically led to a prostate biopsy, but instead we are using additional tests to help us understand whether a given person with an elevated PSA really is at risk of prostate cancer and should undergo a biopsy, or whether we can use these tests to rule out those men that really do not need one no-transcript.
Dr. Jeff Tosoian:Yes.
Grantley Martelly:So early screening is really important, but it's not necessarily one screen that necessarily tells you everything. So our listeners need to make sure they have a good medical team who is evaluating the whole person and then checking on the early screen but then referring to the urologist or others who can do these other tests before they get to the biopsy, so that they're going through a progression. And then, after I was diagnosed, I even had another test. Yes, the bone cancer test, and then all of those things came together when we finally sat here.
Dr. Jeff Tosoian:Here is what you have and here's what all of them are showing yes, 100%. You know, I always tell my patients PSA is a long way from a cancer test. Right, it is not a cancer test. It gives us a broad indication as to whether we need to take a closer look in terms of prostate cancer. But in and of itself, it tells us it could be the result of just an enlarged prostate, it could be the result of an infection or some inflammation of the prostate. And so you know, I would not ever advise, you know, acting upon a single PSA test alone. But it is. It is a great indicator of whether we need to take a closer look at things. Yeah, it's one tool in the toolbox.
Grantley Martelly:You got it. So this is a great place to transition to the project that you've been working on. That is a great discovery for prostate cancer that we believe is another way of screening and that will help eliminate some of the maybe additional tests that needs to be done. So let's talk about your discovery that you worked on and tell us about that and how it's going to help change the landscape in prostate cancer screening and prostate cancer treatments.
Dr. Jeff Tosoian:Yes, absolutely, and so you know that work, as I mentioned, we started in 2019. And the idea behind it was that, you know, still there were some tests available that are offered for men with an elevated PSA to better identify, as we talked about, whether that patient needs to consider a biopsy or whether it can be. It is one of those cases where the PSA is elevated, but the overall risk of cancer is still very low to where a biopsy would not be necessary. And those tests were, you know, developed around a decade or so or more ago, and they improved upon PSA in that, rather than just being a marker for prostate and potentially for prostate growth, there were a series of tests that came out where, in either the blood or the urine, we were able to identify markers that were truly associated with cancer, and each of those proved to improve upon PSA.
Dr. Jeff Tosoian:Now, there were some limitations of those. One is that each of those tests incorporated was just a marker of prostate and prostate growth to tests that used either two, three or four markers that were more specific for cancer enabled us to identify another proportion of those men with elevated PSA that really did not need to undergo a biopsy. The limitation of those tests, however, was that one: They did only measure up to four additional markers right, and we have many years of research that have now identified several hundreds of markers that are associated with prostate cancer.
Dr. Jeff Tosoian:The other limitation is that, yes, those tests represented a great advancement in that they are specific, or more specific for cancer, or more specific for cancer. That being said, in recent years, as we've talked about, we learned that a proportion of prostate cancers really don't behave like cancer right, meaning that they don't spread and they don't cause harm the way that cancers do, and so you know, those are generally called the low-grade or low-risk prostate cancers, and so the focus of clinical practice, as evidenced in our research and shown in national guidelines, is that we need to be seeking to detect the other cancers, the more aggressive ones, the ones that do have potential to cause harm, and the term that's often used for that is clinically significant prostate cancer. So folks will say clinically significant prostate cancers, meaning Gleason score seven or higher or grade group two or higher.
Dr. Jeff Tosoian:Those are the ones that, generally speaking, if detected, are recommended to undergo treatment, because we know that they can cause harm over over time, and so we thought well, if we can develop a new test that A includes more than just three or four markers, will do a better job of identifying these different pathways that can lead to prostate cancer.
Dr. Jeff Tosoian:Include some of the newer markers, some of which were discovered in our lab that are specific for the higher-grade prostate cancers, meaning that these levels are elevated to a higher extent in cases of high-grade prostate cancer than they are in low-grade prostate cancer, and certainly than they are in non-grade prostate cancer and certainly than they are in non-cancerous prostate tissue.
Dr. Jeff Tosoian:We could develop a more accurate test, and so, over the course of several years, starting with publicly available data, looking at the genetic expression of cancers in large data sets, we identified around 50 markers that appeared to be elevated in prostate cancer, some of which 17 of which were specifically elevated in higher grade prostate cancers, and we did that in tissue, so in prostate tissue, and the important thing, though, was that right, if you're looking at tissue, that means you've already done a biopsy, and we wanted to develop a test that could prevent those biopsies, and so we looked at those markers in urine and tested whether we could measure them successfully in urine, and found that the vast majority of them we could, and so then it became a matter of looking in the urine of many, many, several hundred patients with an elevated PSA level, some of which had gone on to be diagnosed with cancer, some of which had a biopsy but there was no cancer, and we were able to filter those 50 or so markers down to the most important 18 markers, and those are the tests that make up the current clinically available test, which is called my Prostate Score 2, 2.0, or MPS2.
Dr. Jeff Tosoian:We then applied that to a separate population of around 700 patients who similarly had an elevated PSA and underwent biopsy, and we found that if those patients had used this test, the MPS2 test had used this test, the MPS II test between, depending on exactly the population, between one-third and one-half of those unnecessary biopsies that were performed could have been completely avoided, while still detecting upwards of 95% of the clinically significant cancers that we set out to detect. And so you know, what we were able to uniquely do, also in that study, is compare the new test to two of the existing tests, one of which was the original my Prostate Score, and we were able to compare the MPS-2 against tests in terms of the ability to identify more and more men that do not need a biopsy, while continuing to correctly identify those that do need a biopsy because they do harbor a significant prostate cancer.
Grantley Martelly:So today we're announcing the availability of my Prostate Score 2.0 for all men around the world, another test available that will help screen not just screen for prostate cancer, but also screen for how aggressive that prostate cancer is. I may, in some cases, eliminate the need for a biopsy or early biopsy in screening a prostate cancer. This is a game changer for many men. This is a game changer for the industry as far as we as patients are concerned. Our former patients, our patient advocates are concerned because we know that there are many men who avoid going to the doctor, to avoid the blood tests or the other tests. But now this test can be done in urine and we are excited about it my prostate cancer 2.0. And we're talking to a person who actually made it happen. So congratulations, dr Tassoyan, and there are going to be millions of men around the world who will have your picture up on their refrigerator.
Dr. Jeff Tosoian:I hope not Many lives. No, it's. Obviously it was a great team effort. There are dozens of members of our research team that contributed to this work, not the least of which I years of work now available as a a test for for patients. Right, it gets back to that first year med student that was, you know I was excited by the idea of being able to, to do something that could help out Um, and here you know, it's now a urine test. Um, that can be done from home. There's at-home testing.
Grantley Martelly:Tell us how we can get it.
Dr. Jeff Tosoian:Yes, so the lab that runs the test is based out of Ann Arbor, michigan. It's called LynxDX, so that's L-Y-N-X-D-X and the website is lynxdxcom. From there, you know, patients can learn about the best way to go about having the test ordered. It does need to be ordered by their provider, and you know all that information is is similarly available on the website, um, and you know you had asked about the the best, best cases for use, and so that would be, you know, absolutely. Men with an elevated PSA, particularly in that range of 3 to 10, which we call the PSA gray zone. This test, you know we provide a urine specimen and the result actually provides the percentage risk. So from 0 to 100% the risk that if you were to go ahead with a biopsy, what is the likelihood that that biopsy would detect a clinically significant prostate?
Grantley Martelly:cancer. So the patients need to ask their doctor about this test. If the doctor doesn't bring it up, that's why we want to announce it to our listeners. To ask the doctor about the myprostate cancer 2.0, or MPS 2.0 test. Is it available to them, how they can get it and would it be helpful to them? Can you just buy it on Amazon or anywhere without a doctor's prescription, or do you need to see a doctor in order to get access to MPS 2?
Dr. Jeff Tosoian:Yes, so at this point, it does still need to be ordered by a clinician, so a doctor or a nurse practitioner, advanced practice provider, and that can be done. I am really, really impressed by what the team has done in terms of the ability to order this test from the clinician side is very, very straightforward, very easy. There's an online portal. It really only takes a minute and it can be sent. Only takes a minute and it can be sent. You know, the test kit can be sent directly to the patient's home or, you know, if a clinician knows that they'll want to be sending the test, they can have the kits there in the office. But at this point, it does still need to be ordered by a clinician, by a healthcare provider.
Grantley Martelly:Well, that is great news. Again, dr Sasanian, thank you. And as we wrap this up here, in the next 90 seconds or so, what is your greatest advice that you want listeners to take away from this episode today?
Dr. Jeff Tosoian:Yeah, you know I would say, like we talked about and like I think you've done a great job of emphasizing that, you know there's only a 20 or 25% chance that that biopsy would would prove to be worthwhile.
Dr. Jeff Tosoian:Um, meaning that you know around 80% of those were negative in the past. Now get the blood tests, the PSA as a starting place, and if that is elevated, certainly there there are other tests that do a very good job as well as MRI. Imaging with MRI is also an option to where I do like the idea of using a test where, if it's negative, we know that the risk that we're not doing a biopsy but that that's the wrong thing. We know that the risk of that is incredibly low and the data for MRI are not quite as good in that regard. But both of the tests combined certainly have a role. But this is not the inexact science that it was 30 years ago. Things have come a long way and the former idea that PSA testing could be a bad thing, that was throwing the baby out with the bathwater, and so now we've found a way to throw out the bathwater but hang on to the baby, you know, make sure we're doing the right thing without putting patients through unnecessary testing.
Grantley Martelly:Thank you, Dr Tasayan, so much for coming on the program today and introducing this MPS2 test the game changer we believe in the prostate cancer world, but also for your information about all of the broader aspects of prostate cancer, how we can approach it work, and for your research and your dedication, on behalf of all the patients out there, for bringing this test to the market. Every tool we have in the toolbox is important in saving lives, and the purpose of this podcast has been to educate people to listen to the stories of men who've gone through it, but also bring the current research and current medical practice to the forefront so that our goal is to save lives. Our goal is to reduce the lethal outcomes for prostate cancer and other health care concerns in people of color. So thank you for your work and thank you for your dedication.
Dr. Jeff Tosoian:Thank you for having me on to talk about this, but, as importantly, if not more importantly, everything you're doing as well. Between this podcast and being a patient advocate like you are, as we've discussed offline with our friends and colleagues, involving patients, involving the community in what we're doing has to be our way forward, right. Patients need to know that the work we're doing is for all of us, right For them, for all of us, our only goal is to reduce the harm caused by, in my case, cancer and prostate cancer, and so the work you're doing is incredibly important and appreciate you and so grateful to have gotten to know you.
Grantley Martelly:Well, thank you very much and we'd have to have you back again to talk some more about urologic health for men. But thank you today and I really appreciate it. My pleasure. Realhealthblackmen@ gmail. com To support this podcast. Go to BuyMeACoffee. com forward slash RealHealthBlackMen, buymeacoffee. com RealHealthBlackMen and to become a corporate sponsor, send us an email.
