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Genomic Testing

What is Genomic Testing?

Genomic testing is done on cancerous tissue taken from the prostate in order to provide information about how your prostate cancer might behave. By looking at the genetic makeup of the cancer, these tests may help predict whether your prostate cancer grows slowly or aggressively.

Genomic testing can be performed on both biopsy tissue and on tissue from an entire prostate following a prostatectomy.

Who Should Get a Genomic Test?

These tests are useful for helping men and their physicians decide on a strategy for managing treatment, so they are often most helpful for men newly diagnosed with prostate cancer that is still confined to the prostate. However, men who have had a surgery and want to understand their risk of five-year recurrence may also find certain tests helpful.

Determining who needs treatment for prostate cancer has evolved with new options to diagnose aggressive vs. indolent disease. Check out our infographic with more information on what genomic and advanced tests are available based on a man’s individual cancer.

Watch Dr. Lowentritt of Chesapeake Urology discuss genomic testing for prostate cancer in the video below:

What Can Genomic Testing Tell Me?

In early stage or localized prostate cancer, where the cancer is still confined to the prostate, there are three types of risk categories:

  • Low-risk prostate cancers that are unlikely to grow or spread for many years
  • Medium/intermediate risk prostate cancers that are unlikely to grow or spread for a few years
  • High-risk prostate cancers that may grow or spread within a few years

Genomic testing can help men find out their risk category, and therefore which treatment options are available to them.

Genomic Testing and Demystifying Your Diagnosis

After a prostate cancer diagnosis, trying to understand all the treatment options available can be mind-boggling. An unclear path forward can leave men susceptible to both over-treatment, with all the unnecessary side effects, or under-treatment, which leaves the risk that the cancer will continue to grow. In many cases, genomic testing can help. This webinar, featuring speakers Dr. Kelvin Moses from Vanderbilt Cancer Center and Monica Bryant from Triage Cancer, will help men newly diagnosed with prostate cancer understand when, why, and how to receive genomic testing. This webinar took place on Monday, May 16th, at 4pm EST. Find the recording here.

Click here to access the full slide deck of our previous webinar, Beyond the PSA: Genomic Testing and Localized Prostate Cancer

Click here to access our previously recorded webinar, Understanding Prostate Cancer in the Age of Personalized Medicine featuring Dr. Michael Brawer.

How Can I get a Genomic Test?

It’s important to talk to your doctor to find out if you are a candidate for a genomic test. There are several tests available today. Current tests include:

  • Oncotype Dx:
    • This test looks at the activity of certain genes in the prostate tumor and assigns a personalized result, called the Genomic Prostate Score, to each case. This number predicts the chance that the disease will be more aggressive and spread to other parts of the body if left untreated. This is used after a confirmed prostate cancer diagnosis of low risk disease and uses biopsy tissue to predict likelihood of future growth and spread. It is helpful for those considering active surveillance.
  • ProstaVysion:
    • This test looks at a sequence of certain genes and provides a personalized genetic panel to determine aggressiveness. This is used after a confirmed prostate cancer diagnosis and uses biopsy tissue to predict likelihood of future growth and spread. It is helpful for those considering active surveillance.
  • Prolaris Test:
    • The Prolaris test measures how fast your cancer cells are dividing to predict aggressiveness. This is used after a confirmed prostate cancer diagnosis of low risk disease and can use both biopsy tissue and tissue from a radical prostatectomy to predict likelihood of metastasis, biochemical recurrence, and death from prostate cancer. It is helpful for men deciding on a treatment option or trying to decide on additional treatment after surgery.
  • Decipher:
    • Decipher Biopsy is available for patients diagnosed with localized prostate cancer at time of biopsy. Decipher Biopsy can help men and their doctors determine if it may be safe to consider active surveillance, treatment, or a combination of therapies. No additional procedure for the patient is needed to run this test.
    • Decipher Post-Op predicts the likelihood of prostate cancer metastasis for men with adverse pathology after radical prostatectomy. The test can help patients and their doctors decide if additional treatment is needed after surgery. Decipher Post-Op uses a tissue sample that was removed during surgery, so no additional procedure for the patient is needed.

What Are Genomics?Genetics-vs-Genomic

Genomics is the study of all the genes in the genome and their interactions with the environment. This is related to but not the same as genetics, the study of individual genes and inherited traits from one generation to the next.

The study of genetics in prostate cancer is important because family predisposition may be responsible for 5-10% of all prostate cancers1. A family history increases a man’s risk for prostate cancer by 60%.

Genomics in prostate cancer looks at how certain sets of genes in the prostate cancer tumor interact and function. The activity of these genes can then influence the behavior of the tumor, including how rapidly it is likely to grow and spread.

Bryce Olson, a 45-year-old husband and father of a young daughter was recently diagnosed with stage 4 metastatic prostate cancer. Hear how he is staying ahead of his cancer by finding the genetic factors that fuel it through the new world of personalized, molecular treatment.

[1] http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-047079.pdf