Custom-Fit Treatments for Prostate Cancer

The individualized treatment strategies that have been used for many breast cancer patients have inspired researchers to look for new options to treat prostate cancer tumors in men.  While more aggressive treatment options may be best for some men with high-risk cancer, less aggressive options may work better for others.  Radiation plus hormone therapy is often used to kill prostate tumors, but Memorial Sloan-Kettering Cancer Center researchers think that taking a look at the DNA of a tumor could actually determine which patients could avoid hormone therapy and its side effects.

High-risk tumors could be separated from lower-risk ones with new kinds of genomic prostate cancer tests, which help doctors determine the best treatment strategy.  Many of the 240,000 men who are diagnosed with prostate cancer each year are at low risk, and experts fear that over-treating the disease can increase the risk of side effects like impotence and incontinence unnecessarily.  

The Gleason score is a measurement used to determine those who have an increased risk of the cancer spreading past the prostate gland, which accounts for roughly 20% of those diagnosed each year.  Most with high-risk forms of the disease undergo hormone therapy or have the gland removed altogether, but usually not both.  Yet, high-risk female breast cancer patients are usually treated with a combination of options, which is a more aggressive approach.  While more research needs to be done on combined treatments for prostate cancer, genetic tests have been shown to help determine the risk level and treatment options for tumors.

Doug Golkinow, chief executive of Genome DX Biosciences, a San Diego company that markets one of the genetic tests that examines tumors, says, "it sorts out a lot of confusions by telling you whether you have the kind of disease that's going to kill you or not kill you. " Prostate cancer claims the life of 1 out of 36 men.

The Wall Street Journal, 1/13/14