NC State alum T. Ming Chu developed a prostate-specific antigen test, revolutionizing prostate cancer detection. His journey from Taiwan to NC State laid the foundation for a career that has impacted millions of lives worldwide.

Chu graduated from National Taiwan University in 1961 before arriving in the United States in 1963. He pursued a master’s degree in food science at NC State, graduating in 1965. He then earned a doctorate in biochemistry from Pennsylvania State University in 1967.

At NC State, Chu established an endowment in honor of his mentor and professor, Leonard W. Aurand, a distinguished scholar in enzymes, lipids and flavor biochemistry at NC State. Aurand recommended Chu to his mentor at Penn State, where Chu received his doctorate. 

After postdoctoral fellowships, he joined Roswell Park Comprehensive Cancer Center in 1970, where he became director of cancer research in 1977 and professor of experimental pathology at the State University of New York at Buffalo. 

At Roswell Park, Chu led a team that sought a protein marker linked to prostate cancer. 

Dr. Matthew Nielsen, professor and chair of urology at the UNC-Chapel Hill School of Medicine, said Chu’s development of the PSA test revolutionized prostate cancer detection, ushering in what he said experts now refer to as the “PSA era.”

“His contributions were really transformational for literally millions and millions of men and the people who care about them, not just in the U.S., but all around the world,” Nielsen said.

Prior to the development of the PSA test, Nielsen said less than 5% of men were able to find out they had prostate cancer while it was potentially curable.

The PSA test is a blood test that targets prostate-specific antigen, a protein uniquely produced by prostate cells. Nielsen said the test uses antibodies specific to this protein to detect prostate disease, particularly cancer, radically transforming patient care by allowing for earlier detection.

Chu’s test received FDA approval in 1986 as a monitor for treatment response and disease recurrence, and in 1994 as an early detection aid. Since then, an estimated one billion PSA tests have been administered worldwide.

Chu’s work has garnered numerous accolades, including the Presidential Award of the American Urological Association and recognition by the American Association for Cancer Research as one of the “Landmark Scientific Discoveries of the 20th Century.”

Although the test was widely embraced for early detection, it faced a period of decline following concerns about overdiagnosis and overtreatment. Studies emerged questioning the overall benefit of widespread screening, leading the U.S. Preventive Services Task Force to recommend against routine PSA testing in 2012. As a result, Nielsen said rates of PSA testing decreased and, subsequently, so did the number of new prostate cancer diagnoses.

However, this decline had unintended consequences.

“Now the rates of prostate cancer are starting to creep up again, but a larger fraction of men who are diagnosed now are diagnosed with advanced disease,” Nielsen said. “So it’s sort of like we’re back to the future.”

Recognizing the drawbacks of diminished screening, Nielsen said urologists have since shifted towards a more personalized approach. Today, the PSA test is often combined with other tools like the MRI and used in conjunction with active surveillance for low-risk cancers, allowing for more selective identification and treatment of aggressive disease. 

Chu’s journey from Taiwan to NC State exemplifies the contributions of Asian Americans in science and education. Crystal Chen Lee, associate professor in English education at NC State and a daughter to Taiwanese immigrants, said Chu’s pathway to the U.S. as a graduate student was fairly common among Asian immigrants at the time.

“Many Asian Americans who are in academia, they also came here for graduate school,” Lee said. “I actually am a product of that. … That was the pathway for a lot of Asian Americans to come to America, especially Taiwanese Americans, because America was very friendly to Taiwanese, especially through the graduate school path.”

The “friendliness” that Lee mentions toward Taiwanese immigrants during this period can be attributed to a complex interplay of factors. The U.S. had separate quotas for mainland China, Taiwan and Hong Kong, which meant that Chinese immigration into the U.S. came almost exclusively from Taiwan in the mid-1970s.  

The Immigration and Nationality Act of 1965, also known as the Hart-Celler Act, played a pivotal role in reshaping immigration patterns. It prioritized skilled workers and those with advanced education, which opened doors for many Taiwanese students seeking graduate degrees in the U.S. This act, coupled with the political alignment between the U.S. and Taiwan, created a welcoming environment for Taiwanese students.

Lee also noted that in the mid-20th century, the U.S. tended to accept more immigrants from certain Asian countries than others, such as Taiwan. This selective acceptance, driven by Cold War politics and a need for skilled labor, meant that individuals like Chu had opportunities that were not as easily available to those from other Asian nations. 

Lee said these immigration patterns have lasting impacts. 

“Many Asian Americans who have really come here for graduate school have contributed to science and contributed to the growth of the American economy and research development,” Lee said.

Nielsen said Chu’s contributions to science have changed the world.

“The world is a completely different place because of the contributions he made,” Nielsen said. “He’s one of many examples of people who came from all over the world and availed themselves of the opportunities that were available here and made a massive impact on humanity.”