More than 220,000 American men receive a prostate cancer diagnosis each year. Many of these diagnoses are treatable thanks to advances in genomic testing and technological and clinical innovations.
The first step to early detection is understanding your risk. Prostate cancer develops naturally in most men as they age, but some families may be predisposed to specific cancers due to their genetic makeup. The inherited risk of prostate cancer is estimated to be as high as 60 percent, although only five to 10 percent is thought to be related to genetic susceptibility genes. Your risk is additionally elevated if your father or brother have or have had prostate cancer, especially if they were diagnosed at a young age.
For instance, the BRCA gene mutation, which is inherited, can manifest in the breast, pancreas, ovaries or within the prostate. Therefore, if you have several family members who have been diagnosed with any type of cancer—especially breast cancer or prostate cancer—it’s important to meet with a genetic counselor who can best define your risk of a particular cancer. Your doctor can then determine the benefits of testing for specific genetic mutations.
If you have been diagnosed with prostate cancer, there are new diagnostic tools affording doctors the ability to differentiate the aggressive cancers from the complaisant ones. In addition, research has provided critical insights; new findings on genetic changes linked to prostate cancer have helped scientists develop a better understanding on how the disease progresses. Perhaps one of the biggest advancements in cancer diagnosis and treatment is the ability to perform genomic testing on certain cancers.
While cancers can look the same under a microscope, they can act differently in each patient. Genomic tests allow us to navigate each patient’s cancer journey with extreme personalization—from diagnosis through treatment—addressing both the overtreatment and optimal treatment of their specific cancer.
There are a number of tests for prostate cancer that aid in predicting the risk of cancer recurring or the possibility of a current cancer spreading to other parts of the body. Results will determine whether active surveillance or a combination of treatments is necessary: surgery, radiation and hormonal intervention.
For example, testing provides necessary information that determines whether or not there is benefit to androgen suppression—a treatment that lowers testosterone levels. While androgen deprivation therapy has shown to have a positive impact against the development and metastasis of prostate cancer, it can also have negative side effects, such as hot flashes, weight gain, increase in arthritic pain and trouble sleeping. Knowing in advance how effective this therapy will be for a specific type of prostate cancer can help spare some patients from negative side effects.
While new tests are being developed, existing technologies are being improved and modernized to more effectively treat prostate cancer. Current methods including conformal radiation therapy, intensity modulated radiation therapy and proton beam therapy, have increased the efficacy of radiation therapy while reducing side effects, such as damaging healthy tissue, helping patients recover more quickly. New drug therapies are also being used to target specific parts of the cancer cells and their surrounding environments, altering the way cancer cells grow and divide.
We also use robotic equipment in almost 90 percent of prostate surgeries. This minimally invasive alternative allows patients to get back to their normal life faster, with less blood loss, scarring and pain.
Personalized care for prostate cancer is a necessity. Advances in genomic testing will continue to provide more direct and targeted therapies, resulting in more patients becoming survivors.
Meri Atanas M.D., is the chief of the Department of Radiation Oncology at Rochester Regional Health’s Lipson Cancer Institute. Atanas specializes in treating prostate, head, neck and breast cancers. The Lipson Cancer Institute provides comprehensive cancer care in one integrated program, in which experts in medicine, radiation treatment and surgery work together with patients and their families to develop a personalized treatment program.
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