You’ve probably heard the term “personalized” or “precision medicine” recently and wondered, what exactly does this mean. The phrase, the buzziest of buzzwords in health for 2015, means a new approach to medicine has arrived, one that is individually tailored to each patient. Where does this begin? Your genes. Every cell and gene throughout your individual genetic profile is taken into consideration when it comes to diagnosing, treatment and even preventing diseases. To take it ever further, genetic testing may be able to predict which diseases you’re at risk for early in life, and because time is on our side, a prevention plan is possible.
When it comes to diagnosing and treating cancer, most oncologists have used the same approach, even though most are aware drug treatments may work on some patients and fail in others. I’m not indicating that all cancers are treated the same, but the basic approach, process and standard of care is used for diagnosing, staging and recurrence.
Oncologists have always known that treating cancer cannot be classified with a standard approach. Why? Because it’s a disease that very much develops and progresses based on factors made up in an individual patient’s genetic profile. As similar as our bodies our, the genetic makeup is completely different. Therefore, why would it make sense to treat cancer with any other approach than individualized care?
Genetic testing is changing the face of how many cancers are diagnosed and treated, and prostate cancer has been one of the diseases at the forefront of this technology. Enter the 4K Score test. This new genetic test 4K score is a simple blood test measuring 4 different prostate-related proteins that provide a percent risk score of having an aggressive prostate cancer. This new tumor marker is an optimized screening and diagnostic test for prostate cancer that assesses the risk of prostate cancer to further indicate the need for a biopsy. Why does this matter? Because the PSA blood test, which has been the only prostate cancer screening available, is non-specific to prostate cancer and can lead to false-positives. The 4K Score test was specifically designed to distinguish between high-risk and low-risk cancers. If we can detect that a cancer is high-risk earlier, we can be sure to perform the biopsy. If the cancer is low-grade, unnecessary biopsies can be avoided. This means not all men who have an elevated PSA will require a biopsy.
This year, the 110th Annual Scientific Meeting of the American Urological Association, presented findings on new genetic testing for prostate cancer screening. Experts explained that diagnosis needs a much more intelligent approach. There were four studies reviewed and the results showed how genetic testing changes the process of diagnosis. The findings determined 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 bio markers for prostate cancer to PSA results to increase 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
The breakthrough here is the role genetic testing plays in cancer, throughout the entire process, from diagnosis to recurrence. We can gather more information about the patient at each step of the way.
How does it work? The PSA test does not clearly distinguish between prostate cancer and less serious conditions. It is simply not specific for prostate cancer. Controversy surrounds the PSA test because it has been thought to result in many men having unnecessary prostate biopsies. There are more than one million prostate biopsies performed in the United States each year. Only 20 percent detect aggressive prostate cancer while 80 percent of prostate biopsies are either negative or detect a low-grade, non-life threatening form of prostate cancer.
The benefits of the 4Kscore test is that it helps reduce the number of unnecessary biopsies, by measuring a man’s risk of having aggressive prostate cancer. If that risk is low, your urologist may decide not to do a prostate biopsy. It also avoids the associated pain and complications such as bleeding and infection that may result in having a prostate biopsy. You may also be able to avoid treatment if the risk for prostate cancer is low and non-life threatening.
These tests are in no way a replacement for the PSA blood test, but a further examination of a man’s risk for the disease. The PSA is still a valuable tool for screening and remains the gateway to detecting the risk for prostate cancer. This test should remain a staple in a standard check-up for men ages 40 and up. If the PSA is elevated and the patient is referred to a urologist, genetic tests like the 4K Score are an excellent option, especially for men with a family history or another known risk factor.
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.
We cannot treat each cancer the same. Not all Gleason scores of 6, 7 or 8+ can be treated equally. With prostate cancer and many other cancers, we must individualize the care and now we can with new genetic testing diagnostic tools available. We can gather more information about the patient’s case at each step of the way. This is a game changer.
