New tests and methods take on the most commonly diagnosed cancer in men
Prostate cancer is the most commonly diagnosed cancer in males, with
about 240,000 diagnoses expected this year. And there are 2.5 million
people currently living with this disease. Recently there have been some
dramatic changes in the way prostate cancer is diagnosed and treated.
Wayne Waltzer, MD, Chairman, Department of Urology, Stony Brook Medicine
explains these major medical advances and what they mean for men across
the nation.
“With prostate cancer being the
number one solid organ cancers in most country, it is important for all
men to be vigilant about getting screened,” says Dr. Waltzer. “And a
newly developed series of genetic tests is now offering a more accurate
and individualized approach in identifying and treating prostate
cancer.”
Currently there are various blood
tests in use. One is called the Prostate Health Index (PHI) and the
other is called the 4K test. Both measure the variance of the PSA in the
blood and are designed to reduce the number of unnecessary negative
biopsies that detect only low-grade cancer. “This means that not all men
with elevated PSA levels will require a biopsy, with its potential for
complications and side effects,” says Dr. Waltzer.
There are also new tests available that help to further individualize
biopsies, if one is required. “If the biopsy is positive for cancer, two
tests — the Polaris and the Genomic Prostate Score — help doctors
distinguish between aggressive cancers that need treatment and those
that are slow growing and may need only the “watch and wait” approach,”
says Dr. Waltzer. “These tests work by measuring a series of genomic
patterns to reveal how the cancer cells are wired to behave.”
If the biopsy is negative but you still have elevated PSA levels,
there is now a test called Confirm MDX that helps ensure that cancer
cells were not missed during the biopsy. “The biopsy may have sampled
tissue that was in an area where there were no cancer cells,” says Dr.
Waltzer. “This could give you a false negative. This new test looks for
hyper methylation, which indicates the presence of individual prostate
cancer tissue near the site of the biopsy.”
If no hyper methylation is detected, the biopsy is considered negative.
If some is detected, additional testing will be needed. Another test,
the PCA3 test is also available in case of negative biopsy. This
gene-based urine test offers additional information on the probability
of finding prostate cancer in the biopsy.
In
addition, if you have had prostate cancer surgery, there are genetic
tests post-surgery that help determine whether additional treatment is
needed based on the genetic composition of the cancer cells and the
risks associated with it.
“These new tests,
which are available at Stony Brook Medicine, are absolutely the future
for cancer diagnostics — and not just for prostate cancer,” says Dr.
Waltzer. “These innovations are happening for almost every form of
cancer, with more on the horizon.”
Dr.
Waltzer says, gene analysis of tissue, the study of genetic markers,
patterns, sequencing and abnormalities, is providing physicians with
unprecedented information on who to treat and how to treat them. “Not
only is it helping us to find the most appropriate approach and
treatment for people with cancer, but it also keeping many people with
the less aggressive forms of the disease from undergoing the rigors of
treatment unnecessarily. This is both a health issue and a quality of
life issue.
The fact that we can take such a
highly individualized approach for very specific forms of cancer also
means that we can look forward to better and more predictable outcomes.”
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