Genomic testing can tell prostate cancer patients whether their disease is aggressive or slow-moving, helping them make informed treatment decisions.
When Jim Green’s doctor told him he had an elevated prostate-specific antigen (PSA) score, he wasn’t worried. “I was absolutely sure that I didn’t have prostate cancer,” he says. “but then I had a biopsy, sat down with my doctor, and the first thing he said was, ‛Jim, you have prostate cancer.’”
Jim’s not alone — nearly 200,000 men will be diagnosed with the disease this year. He’s also not alone in his initial confusion about treatment options. “I went home and the emotional part of it hit me,” Green recalls. “I’ve had friends who have prostate cancer. One had his prostate removed — he said, ‛Don’t let him take it out.’ He went through this litany of problems that he was having.”
Jim’s doctor told him he likely had a slow-moving cancer and active surveillance could be a possibility. Then Jim learned about the Oncotype DX Genomic Prostate Score® (GPS™).
Lack of information
“Patients usually have uncertainty on what treatment is best,” says Andrew J. Stephenson, M.D., section chief and director of urology oncology at Rush Medical College. “The GPS test allows the clinicians to look ‘under the hood’ and behind the scenes of what’s going on with the cancer. At the molecular level, you see which genes are turned on or off. This allows for more information on how that cancer is going to behave.”
For Jim, this was a game-changer. “I got a call from my doctor, who told me about a test they do out in California, the Oncotype DX GPS test. It looks at your tissue [from your prostate biopsy] and determines how aggressive your cancer is. When my doctor said ‛Well, it looks like you have a slow-growing cancer, that’s confirmed by the GPS test’ I was able to say, ‘OK, now I’m really ready to make some decisions,’” and Jim was able to decide to continue with active surveillance confidently.
Active surveillance
“In some cases, the risks of treatment may be more detrimental than the risks the cancer poses to the patient,” says Dr. Stephenson. “If they are open to active surveillance, I tell them we need to learn more about their cancer to get confirmation that it’s safe. Repeat biopsy, MRI, and the GPS test are often used to ensure we’re getting an accurate picture of the cancer. Of all the tools in the toolbox, genomics (the GPS test) is the most reliable.”
The Oncotype DX GPS test gave Jim peace of mind. “The GPS test opened everything up for me — it was like a weight lifted off my shoulders. Because I know a lot of people when they hear they have cancer, it’s ‛Let’s do all the treatments that they can do,’ but every one of those treatments has side effects.” His experience under active surveillance has been ideal. “I had one more biopsy about three years ago,” he reports, “and the cancer had somewhat even regressed!”
Jim believes men need to be more proactive about their prostate health. “Younger men don’t get tested enough,” he says, “because it’s something that’s off their radar screens. My biggest advice to people who hear they have prostate cancer is to get the biopsy, and if you can have a genomic test done — do it. We are all responsible for our healthcare — getting information and making good decisions. There is a better way to deal with it than panic.”