NEW YORK, May 28, 2015 /PRNewswire/
“Due to innovative genetic testing methods, we’re getting smarter around not only the diagnosis of prostate cancer but who needs surgery and which patients should watch their cancer. This is a huge shift in this field,” said Dr. Samadi, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital in New York City.
As presented at the 110th Annual Scientific Meeting of the American Urological Association last week, prostate cancer screening needs a more intelligent approach.
Results of the studies revealed how urologists can:
- Determine frequency of prostate cancer screenings based on PSA levels and risk factors
- Integrate the Prostate Health Index (PHI) to distinguish aggressive prostate cancer from slow-growing forms
- Apply genetic biomarkers for prostate cancer to PSA results to increase the accuracy of risk for prostate cancer and avoid unnecessary biopsies
- Assess genetic profile associated with prostate cancer to better identify high-risk patients and men who may benefit the most from prostate cancer screening
“I see hundreds of men each month and we’re already using this approach. The foundation stems from treating each patient individually and now genetic testing can prove even earlier how high a man’s risk for prostate cancer is,” noted Dr. Samadi.
The game-changer here is the role genetic testing plays throughout the entire process, from diagnosis to recurrence. If a man’s PSA is elevated, new genetic tests such as the PHI (Prostate Health Index), 4K Score, PcA3, and Prostate Biopsy can further indicate activity around the prostate as well as support whether to get a biopsy or not. If a biopsy returns positive, the next step is directing the right prostate cancer treatment for each patient. Other genetic testing methods such as Prolaris, OncotypeDx, Prostavysion, and testing for hereditary PCa and genes like BRCA, will give more information regarding the risk factors, growth rate, aggressiveness, and risk of morbidity of cancer.
“Now that we’ve moved from Ultrasound to MRI, in combination with these genetic tests, we may actually be to able crack the code and diagnose aggressive prostate cancer earlier. And of course, this leads to the right treatment path for each patient,” said Dr. Samadi.
Next is treatment evaluation. If surgery is recommended, the prostate gland can be analyzed to evaluate the likelihood of metastasis and/or biochemical recurrence using the Genome Dx/Decipher test or following the trend of the patient’s PSA and how soon after surgery it increases. If the cancer comes back, radiation can be used as a secondary treatment for cases more likely to occur. Being able to identify risk factors earlier is a breakthrough.
“We cannot treat each cancer, such as Gleason scores of 6, 7, or 8+, the same. With prostate cancer, we must individualize the care and now we can with new genetic testing diagnostic tools. We can gather more information about the patient’s case at each step of the way,” stressed Dr. Samadi.
“Even further, these genetic tests will help us better distinguish candidates for prostate cancer surgery versus watchful waiting and if the disease is more likely to recur.”
To take it even further, scientists from the Institute of Cancer Research, UK, analyzed 150 patients with aggressive prostate cancer and found almost 90 percent carried genetic mutations in their tumors. What’s more, almost 20 percent carried the BRCA1 and BRCA2 genetic mutations, which have only been associated with their role in breast cancer.
“Perhaps the future of prostate cancer prevention looks more like breast cancer today. In the next 10 years, we may be recommending men to preemptively remove their prostate because their risk for the disease is so high. Being able to smartly distinguish those patients from those with a much lower risk starts with genetic testing,” noted Dr. Samadi.
Patients newly diagnosed with prostate cancer can contact world-renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free consultation. Call 212.365.5000 to set up your free consultation.