Getting the diagnosis of cancer is usually an overwhelming and emotional process. There are several stages to understanding your disease. After the initial tests have been completed most patients start with the process of determining the next step in treatment with the goal of complete cure. Advances in medical technology and treatments have allowed for tremendous improvement in care. There are several new tests for patients with prostate cancer that can help to predict the timing and need for treatment.
It’s important to understand that all cancer cells do not behave in the same manner. Some cancers can be very aggressive and other cancers can have a very slow growth over many years.
Most men with low or low-intermediate risk prostate cancer can often opt for active surveillance. This is the process of continuing to monitor the disease with intermittent PSA blood testing, prostate biopsy and exam, with the goal of delaying treatments which may have associated risk. A newer option is genetic cell testing which can be run off your existing biopsy tissue, without any additional procedures needed. These tests analyze the DNA inside of the cancer cells to help provide additional information regarding the aggressiveness of the cancer. They can help to predict the next steps and future outcome. These tests can be very helpful to patients when trying to make difficult decisions.
The first test, called Oncotype DX, uses the biopsy tissue to determine if the cancer has a more or less favorable outlook for the future. For example, a less favorable result may help to initiate treatment sooner for a more aggressive cancer. The second test, called Prolaris, provides both predictive testing and also will report your risk of dying of prostate cancer in 10 years without treatment. I recently had a patient who we believed had a higher risk prostate cancer; however his Prolaris test reported his risk of dying of prostate cancer in 10 years at three percent. Obviously, that was a HUGE relief to this patient. Instead of investing energy into his treatment he is spending more time with his grandchildren and family.
I expect that more similar tests will be available in the future for different cancers.
Dr. Lieb is a Board Certified Urologist with Pacific Urology. His practice has offices in Walnut Creek, Concord, San Ramon Brentwood and Livermore. Join Dr. Lieb and Pacific Urology at their annual event: ‘Pints for Prostates’ and Men’s Health Fair at Pyramid Alehouse in Walnut Creek. June 12th from 6-8pm. $20 donation includes beer, beer glass and hors d’oeuvres. Space is limited, reserve by calling 925-677-5041 x272.