New Genetic Test for Prostate Cancer… Hope or Hype?

By: Robert Pugach, MD

It seems as if not a month goes by where we read headlines proclaiming new medical breakthroughs. A recent headline and article in the AARP Bulletin caught my attention. In the article, Brave New Worlds in Diagnosing Diseases, several new promising diagnostic tests, including one about a new prostate cancer assay, were outlined.

The test they discussed was captioned as a “less-guess” prostate test, the Oncotype Dx Prostate Cancer Assay test. While the AARP article implied that this was a brand new test, we’ve actually been using it at Pacific Coast Urology Medical Center for the past 6 months. We’ve been evaluating and using tests like this for the past several years. We made the switch to the Oncotype Dx test because it seems to provide better information than tests promoted by other companies.

The Oncotype Dx test looks at cancer from a molecular level. This new medical field is called genomics. By analyzing DNA sequences in prostate cancer specimens, it has the potential to give us far more precise information about an individual patient’s cancer than a traditional pathologist can do using slides and a microscope. It may become extremely valuable in helping to determine which prostate cancers need treatment and what type of treatment should be provided.

Do tests like Oncotype Dx replace standard prostate cancer screening measures like an annual digital rectal exam (DRE) and PSA blood test? Can it replace prostate biopsies? The answer to both questions is “definitely not.” Screening for prostate cancer remains the only way to determine if a patient may have it. Unfortunately, the death toll from prostate cancer is on the rise. Since the ill-advised recommendations of the U.S. Preventive Services Task Force three years ago, that advised against routine screening for all men, the number of cases of advanced, incurable prostate cancer has risen significantly. Equally worrisome is the fact that it has been responsible for more prostate cancer deaths. In 2011, 29,000 men died of prostate cancer; this year that number will be 30,400.

So, while all men should be screened for prostate cancer, the good news is that new tests like Oncotype Dx may help to target treatments only for those men with more aggressive genetic tumor markers. It may also allow us to develop therapies that target the genetic basis of cancer so that more minimally invasive therapies can be developed.

At Pacific Coast Urology Medical Center, we’re proud of the international reputation we have earned in the field of diagnosis and treatment of prostate cancer. If you haven’t been screened for prostate cancer in the past 12 months call us to schedule this potentially life-saving test.

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