What Does Personalized Medicine Look Like for Prostate Cancer?
The traditional symptom-based approach to medical treatment is being replaced by one that is personalized for you.
Individualized medicine is often the first step in treatment decision-making for cancer care.
personalization of medicine has an impact on the cancer types that include prostrate cancer. Special disease markers are used to decide whether treatment is needed before it begins.
We’ve partnered with the Prostate Cancer Foundation (PCF) to learn more about how personalized, or precision, medicine is used for prostate cancer.
From screening to treatment, precision medicine is used for the treatment of prostrate cancer.
Dr. Rana McKay is a medical oncologist at the University of California San Diego and PCF-funded researcher.
PSA tests are used to screen for early signs of cancer.
Cancer cells tend to release more PSA than healthy cells, so elevated levels in the blood may suggest that more regular or additional types of testing are needed.
“Even if you don’t have cancer, PSA can be high. It is helpful to observe trends in PSA levels over time.”
Taking your age and other personal characteristics into account, doctors can understand when a person with high PSA levels may have cancer versus another condition.
The best age to begin screening for prostate cancer can be personalized based on your risk factors. The PCF recommends:
- If you have a family history of cancer, you should talk to your doctor about screening at 40.
- If you are black, you should talk to your doctor about screening at 40.
- “If you don’t have any risk factors, you should talk to your doctor about screening at 45.”
The role of precision medicine is more important during treatment. It helps doctors match the right treatment to the cancer you have.
McKay says the goal of precision medicine is to target the right treatments to the right patients at the right time.
There are several treatments and clinical trials that are designed for people with specific changes in their tumors.
“A variety of factors may be considered by the team of oncologists to evaluate the unique characteristics of a person’s cancer type.”
- Specific genetic changes.
- How genes are expressed
- How far the cancer has spread.
Some tests that may be used to evaluate these factors are listed below.
- The tissue is being removed.
- Testing for blood or urine.
- genetic testing
- There are various types of scans, such as PET orCT.
Results from these tests can help healthcare professionals understand.
- How aggressive is the cancer?
- What treatment approaches are needed?
- “Which drugs will or won’t work against a specific tumor.”
For instance, tumors that contain mutations in certain DNA damage repair genes may be more likely to respond to a poly adenosine diphosphate-ribose polymerase (PARP) inhibitor, such as rucaparib (Rubraca) or olaparib (Lynparza).
The tumors that contain mismatch repair genes are more likely to respond to pembrolizumab.
Knowing which medication is likely to work for a specific tumor helps doctors avoid treatments that are unlikely to be effective and minimize potentially unpleasant and unnecessary side effects.
Doctors will consider things like age and health conditions when tailoring treatment plans.
Men over 70 can live with the disease for many years, whereas younger men can die from it.
Men who are younger and healthy have the potential to live for a long time after treatment, which may influence treatment decisions.
Understanding these factors and taking a personalized approach helps your care team determine how aggressive to be with different cancer therapies.
“Doctors can use a feature in a person’s tumor to predict their response to a specific treatment.”
There is still a lot to learn about precision medicine for prostate cancer.
There are only a few genes that can help guide clinical decision-making and predict response to treatment in the case of prostrate cancer.
McKay estimates that most patients have a genomic alteration that could be targeted with a specific drug or combination of drugs.
A 2015 study reported that samples from almost
The study only looked at tumors from people with advanced cancer. These individuals are at the highest risk of dying from cancer and may benefit from a personalized approach to treatment.
McKay says that lifestyle plays a huge role in treatment of prostrate cancer.
Understanding how certain genetic features affect the likelihood that a person will develop cancer can help them take steps to prevent it.
It is known that diet and physical activity can affect your chances of getting cancer. A personalized prevention plan could include these.
Individualized lifestyle plans tailored to individuals could someday help people deal with different responses to therapy and side effects during treatment for prostrate cancer.
A future where a personalized lifestyle plan can be used to help prevent or treat cancer is not far off.
There is research on precision medicine for cancer.
McKay notes that there are many exciting studies on treatments, biomarkers, and other approaches on the horizon.
She is excited about the Alliance for Clinical Trials and the PREDICT study.
She explains that the study uses a novel umbrella study that uses a combination of genes and tumors.
There are several other areas of prostate cancer research that one day will be used to guide personalized treatment approaches. Some of the remaining questions
- When can active therapy be used?
- Who should get surgery?
- Who will benefit from more intense treatment?
- Is drug resistance likely?
- What alterations can be targeted with new or emerging treatments?
McKay says that having enough people from diverse background to conduct studies is what helps advance the field of precision medicine.
She says that participation in clinical research is important for helping patients.
Individualized treatment for men with cancer has been a revolution.
These improvements can help improve outcomes, reduce the occurrence of unnecessary side effects, and set people on the path to recovery sooner.
If you or a loved one is diagnosed with cancer, your doctor should discuss the testing options available to help guide your treatment decision-making.
McKay says it is important to engage with your healthcare clinicians to ensure the best outcomes.