By Johns Hopkins University

This new approach could significantly reduce the need for invasive, often painful biopsies.

By analyzing urine samples from prostate cancer patients before and after prostate-removal surgery, as well as samples from healthy individuals, researchers identified a panel of three biomarkers—TTC3, H4C5, and EPCAM—that robustly detected the presence of prostate cancer.

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These biomarkers were detectable in patients prior to surgery but were nearly absent post-surgery, confirming that they originated in prostate tissue.

The results appear in eBioMedicine.

Prostate cancer, one of the leading causes of death in men in the United States, is typically detected by blood tests to measure PSA, a protein produced by cancerous and noncancerous tissue in the prostate. In most men, a PSA level above 4.0 nanograms per milliliter is considered abnormal and may result in a recommendation for prostate biopsy, in which multiple samples of tissue are collected through small needles.

However, the PSA test is not very specific, meaning prostate biopsies are often needed to confirm a cancer diagnosis, says senior study author Ranjan Perera, director of the Center for RNA Biology at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, and a professor of oncology and neurosurgery at the Johns Hopkins University School of Medicine. In many cases, these biopsies are negative and can result in unintended complications, Perera says. PSA tests also can lead to unnecessary treatment for very low-grade prostate cancers that are very unlikely to grow and spread over a short period of time.

“This new biomarker panel offers a promising, sensitive, and specific, noninvasive diagnostic test for prostate cancer,” Perera says.

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“It has the potential to accurately detect prostate cancer, reduce unnecessary biopsies, improve diagnostic accuracy in PSA-negative patients, and serve as the foundation for both laboratory-developed and in vitro diagnostic assays.”

The panel was found to be able to detect prostate cancer even when PSA was in the normal range and could distinguish prostate cancer from conditions like prostatitis (inflammation of the prostate) and an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).

“There is a real need for non-PSA-based biomarkers for prostate cancer, and urine is quite easy to collect in the clinic,” says study coauthor Christian Pavlovich, a professor of urologic oncology at Johns Hopkins and program director for the Prostate Cancer Active Surveillance Program.

“Most urologists feel that an accurate urinary biomarker would be a valuable addition to our current diagnostic armamentarium.”

During the study, investigators studied biomarkers in urine samples from healthy individuals as well as from patients with biopsy-proven prostate cancer undergoing prostate-removal surgeries at Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, or AdventHealth Global Robotics Institute in Celebration, Florida.

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They studied 341 urine specimens (107 from healthy individuals, 136 from patients with prostate cancer before surgery, and 98 after surgery) during the development of their urine test and an additional 1,055 specimens (162 from healthy individuals, 484 from patients with prostate cancer before surgery, and 409 after surgery) to validate the test.

During the performance evaluation phase of testing, the scientists also studied samples from patients with BPH or prostatitis, and healthy controls, from Johns Hopkins Hospital from 2022 to 2025.

Investigators extracted RNA from prostate cells shed in 50-ml urine samples and analyzed them using RNA sequencing and also real-time quantitative polymerase chain reaction (qPCR) to study gene expression. They also used immunohistochemistry to study biomarkers in samples from cancerous prostate tissue and healthy adjacent tissue, and statistical analyses to compare biomarkers found in the urine and tissue samples.

From an initial 815 prostate-specific genes identified in urine from men with prostate cancers, the investigators prioritized the top 50 genes, then the top nine, and from there selected the three top performers—TTC3, H4C5, and EPCAM—for further analysis.

Overall, expression levels of the three biomarkers were significantly higher in urine samples from individuals with prostate cancers than in urine from the healthy controls. The expression of each biomarker diminished to low or undetectable levels in samples taken after surgery. A greater proportion of patients with prostate cancer tested positive for the three biomarkers than for PCA3, another biomarker associated with prostate cancers, in both the development study and the validation study.

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“This test has the potential to help physicians improve diagnostic accuracy of prostate cancer, reducing unnecessary interventions while allowing early treatment for those who need it,” says study coauthor Vipul Patel, director of urologic oncology at AdventHealth Cancer Institute in Celebration, Florida. Patel also is medical director of global robotics for AdventHealth’s Global Robotics Institute, and founder of the International Prostate Cancer Foundation.

“On behalf of physicians and patient globally, I advocate for further study and progress for these biomarkers.”

Investigators are considering how the biomarker panel could be used alone or combined with a PSA test to make a “super PSA,” Perera says. The next steps for the research are to have an independent trial of the test at another institution and to further develop the test for laboratory use in clinical settings, he says. The investigators have filed a patent, and Johns Hopkins Technology Ventures is helping the team to spin off a company.

Additional coauthors are from Johns Hopkins; Charles University in Prague; the University of Kansas; Orlando Health Medical Group Urology-Winter Park in Orlando, Florida; and AdventHealth Cancer Institute.

Support for the work came from the International Prostate Cancer Foundation, the Johns Hopkins Kimmel Cancer Center, the Bankhead-Coley Cancer Research Program to Perera, and by the Maryland Innovation Initiative Grant to Pavlovich and Perera.

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Bettegowda is a consultant for Haystack Oncology, Privo Technologies, and Bionaut Labs. He is a cofounder of OrisDx and Belay Diagnostics.

Source: Johns Hopkins University

Original Study DOI: 10.1016/j.ebiom.2025.105895

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Previously Published on futurity.org with Creative Commons License

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By Niraj Naik.

Breathing is often thought of as a simple, automatic act, but its impact extends far beyond the exchange of oxygen. The way we breathe directly influences how our body processes food, produces energy, and even rests at night. By understanding how breath affects digestion, metabolism, and sleep, we can tap into a natural, non-invasive method of supporting health.

Modern research is increasingly exploring the impact of intentional breathing techniques on gut health, metabolic balance, and sleep.

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The Science of Breathing and the Nervous System

Breathing acts as a primary regulator of the autonomic nervous system, which governs involuntary functions such as heart rate, hormone release, and gastrointestinal motility. Shallow, rapid breathing typically activates the sympathetic “fight-or-flight” state, while slow diaphragmatic breathing stimulates the parasympathetic “rest-and-digest” mode. This is why breathwork and the nervous system are inseparably linked: breathing patterns signal whether the body should prioritize energy conservation, digestion, or alertness.

Emerging studies show that science-backed breath training can improve vagus nerve activity, reduce stress hormones like cortisol, and optimize gastrointestinal motility¹. This connection forms the foundation of why breathwork for metabolism, digestion, and sleep is increasingly being studied in clinical contexts.

Breath as a Metabolic Regulator

Metabolism depends on efficient oxygen delivery to cells for ATP (Adenosine Triphosphate, a molecule that serves as the primary energy carrier in cells) production, the energy currency of the body. If breathing is shallow or inefficient, oxygen supply decreases, shifting energy production toward less efficient anaerobic pathways. This leads to quicker fatigue, impaired fat utilization, and sluggish energy output.

Practicing breathing exercises for metabolism enhances diaphragmatic engagement, increasing oxygen saturation and improving the body’s ability to metabolize fat for fuel. For individuals trying to sustain a consistent gym routine, combining physical training with breathwork for metabolism supports endurance and recovery by ensuring cells are well-oxygenated.

Clinical research indicates that slow-paced, deep breathing helps regulate blood glucose and improves metabolic efficiency 2. By practicing daily breathwork for metabolism, people may complement their nutrition and fitness programs, creating a minimalist routine for better health that leverages both movement and controlled breath.

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Diaphragmatic Breathing & Digestive Flow

The digestive process is strongly tied to the parasympathetic nervous system. Stress or anxiety often causes shallow breathing, which impairs gastric secretions and gut motility. This explains how breath affects digestion so profoundly: relaxed breathing enhances vagal tone, improving peristalsis and nutrient absorption.

Early studies and clinical observations suggest that practicing breathwork for digestion may reduce bloating, improve bowel regularity, and support digestive enzyme activity 3. Techniques such as diaphragmatic breathing increase abdominal pressure, gently massaging internal organs, and supporting blood flow to the digestive tract.

For individuals struggling with irritable bowel syndrome (IBS) or stress-related gut issues, breathwork and the nervous system play an essential role in symptom management. Incorporating even five minutes of breathwork for digestion daily can significantly improve comfort and meal satisfaction.

How Breath Regulates Sleep

Poor breathing patterns are linked to insomnia, sleep apnea, and restless sleep cycles. Shallow breathing stimulates the sympathetic nervous system, keeping the body in a heightened state of alertness 4 . By contrast, deep nasal breathing supports relaxation and may indirectly influence sleep-promoting hormones and circadian readiness.

Techniques such as the 4-7-8 method, diaphragmatic breathing, or slow alternate nostril breathing have been validated as effective methods of breathing for better sleep. Practicing breathing exercises for metabolism during the day indirectly aids nighttime rest, as better oxygen use reduces cortisol levels and balances circadian rhythms.

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Patients with sleep apnea demonstrate disrupted oxygen flow, highlighting how disordered breathing disrupts restorative rest cycles. By adopting breathing for better sleep strategies, individuals can improve both sleep onset and depth, making breathwork a cost-free complement to sleep hygiene practices. However, while breathwork may improve sleep quality in some individuals, clinical conditions such as sleep apnea require medical evaluation and treatment.

Integrating Breathwork Into Daily Life

Breathwork is most effective when woven into daily habits. For example:

• Before meals: Practice 5 minutes of breathwork for digestion to prime the gut.
• During workouts: Use diaphragmatic breathing to enhance oxygen efficiency and support breathwork for metabolism.
• At night: End the day with breathing for better sleep to prepare the body for deep rest. Such integration creates sustainable benefits without requiring drastic lifestyle changes.

Whether one follows a structured training program or a minimalist routine for better health, the key is consistency.

Frequently Asked Questions on Breathwork

1. Can breathwork really improve my metabolism?

Evidence suggests that breathwork for metabolism can improve oxygen efficiency and cellular energy production. This may enhance fat utilization, exercise endurance, and recovery, especially when combined with a consistent fitness routine.

2. How does breathwork help digestion?

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Practicing breathwork for digestion stimulates the vagus nerve, improves peristalsis, and reduces stress-related bloating. This explains how breath affects digestion directly and why relaxation-based breathing supports nutrient absorption.

3. What are the best techniques for sleep?

The most effective breathing techniques for better sleep include slow diaphragmatic breathing and the 4-7-8 method. These approaches lower heart rate, reduce cortisol, and promote relaxation before bed.

From Energy to Sleep: The Power of Intentional Breathing

Breathing may seem automatic, but the way we control it influences energy, digestion, and rest. Breathwork and the nervous system create pathways that impact everything from gut motility to mitochondrial efficiency. By incorporating breathwork for metabolism, breathwork for digestion, and breathing for better sleep into daily routines, individuals can unlock powerful improvements in overall health.

For those seeking practical and lasting results, the path does not require complex tools or expensive therapies. Instead, a minimalist routine for better health anchored in mindful breathing can provide profound, science-supported benefits.

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References

1. Gerritsen, R. J. S., & Band, G. P. H. (2018). Breath of life: The respiratory vagal

stimulation model of contemplative activity. Frontiers in Human Neuroscience, 12, 397.

https://doi.org/10.3389/fnhum.2018.00397

2. Obaya, H. E., Abdeen, H. A., Salem, A. A., Shehata, M. A., Aldhahi, M. I., Muka, T.,

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Marques-Sule, E., Taha, M. M., Gaber, M., & Atef, H. (2023). Effect of aerobic exercise,

slow deep breathing and mindfulness meditation on cortisol and glucose levels in

women with type 2 diabetes mellitus: A randomized controlled trial. Frontiers in

Physiology, 14, 1186546. https://doi.org/10.3389/fphys.2023.1186546

3. Liu J, Lv C, Wang W, Huang Y, Wang B, Tian J, Sun C, Yu Y. Slow, deep breathing

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intervention improved symptoms and altered rectal sensitivity in patients with

constipation-predominant irritable bowel syndrome. Front Neurosci. 2022 Nov

4;16:1034547. doi: 10.3389/fnins.2022.1034547. PMID: 36408402; PMCID:

PMC9673479.

4. Cowie, M. R., Linz, D., Redline, S., & et al. (2021). Sleep disordered breathing and

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cardiovascular disease: JACC state-of-the-art review. Journal of the American College

of Cardiology, 78(6), 608–624. https://doi.org/10.1016/j.jacc.2021.05.048

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This post was previously published on Mind Body Dad.

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I have worked in the healthcare field for more than fifty years. I began my career working in addiction medicine. After working with men and women suffering from addictions to drugs like alcohol, heroin, and cocaine, I began to realize that addiction is not just about drugs.

We know that people can have addictive relationships with food, work, and even sex and love. In my book, Looking for Love in All the Wrong Places: Overcoming Romantic and Sexual Addictions, I say,

When we find that our romantic relationships are a series of disappointments yet continue to pursue them, we are looking for love in all the wrong places. When we are overwhelmed by our physical attraction to a new person, when the chemistry feels fantastic, and we are sure that this time we have found someone who will make us whole, we are looking for love in all the wrong places.

In the book, I also quoted Dr. Stanton Peele, an authority on addiction who reminds us,

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Many of us are addicts, only we don’t know it. We turn to each other out of the same needs that drive some people to drink and others to heroin. Interpersonal addiction — love addiction — is just about the most common yet least recognized form of addiction we know.

Now Dr. Raphael Cuomo has extended our understanding of addiction even further. In his book, Crave: The Hidden Biology of Addiction and Cancer, he says,

We live in a society saturated with addiction, but not just the kind that ends in emergency rooms or interventions. This is not only about heroin, meth, or alcohol. It is about the relentless cycle of stimulation and reward that defines ordinary life. Binge eating. Compulsive phone checking. Nightly glasses of wine. Doomscrolling. Sugar, caffeine, porn, social media validation, and manufactured outrage.

I had the opportunity to interview Dr. Cuomo. I asked him questions that I thought my readers would be most interested in learning about including the following:

• What first got you interested in the cancer connection and why is this connection both hidden and important?

• If you were talking to a group of guys, what are some of the things you would say to them about how the book could help them?

• Tell us in what ways food is a drug and what do we need to know to keep from becoming hooked?

• What is “Digital Dopamine” and why is it a hidden public health problem?

You can watch my full interview with Dr. Cuomo here.

Most of has have concerns about cancer, know someone who has been diagnosed with cancer, or have fears that we ignore or obsess about. Dr. Cuomo offers a new perspective I found very helpful. He says,

We often think of cancer as a genetic accident. A cell mutates, begins to divide uncontrollably, and escapes detection. The story is partially true. But it omits the most important questions:

What makes the body permissive to that escape?

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Why does the immune system, which identifies and eliminates abnormal cells every day, begin to miss its targets?

Why do repair systems fail to correct damaged DNA?

Why does cellular growth shift from regulated to rebellious?

In ten, information-packed chapters, Dr. Cuomo answers these and many more questions that can help us understand the biology of addiction and cancer:

1. Molecular Scars
2. The Addicted Society
3. Craving is Chemical
4. Inflammation Nation
5. Food as a Drug
6. Digital Dopamine
7. Nicotine, Alcohol, and the Usual Suspects?
8. Beyond the Individual
9. Biology Can Change
10. The New Prevention

In his concluding chapter, Dr. Cuomo says,

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Prevention, as commonly understood, has struggled to match the evolving reality of cancer. Cancer involves more than external exposure. It arises from internal conditions. Disease takes hold when the body’s environment shifts toward permissiveness, inflammation becomes persistent, immune surveillance weakens, insulin signaling grows erratic, and repair mechanisms fall behind damage. These issues arise collectively, resulting from behavioral, emotional, and structural patterns repeated consistently over time.

For more information about Dr. Cuomo and his work, you can visit him here: https://raphaelcuomo.com/

You can watch my interview with Dr. Cuomo here: https://youtu.be/GLuHclBPH4U

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This post was previously published on Menalive.com.

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