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Precision Oncology

Arrows in a target bullseye

New knowledge is beginning to explain the decades-old question of why a treatment may work for one patient but not another. Cutting-edge technologies that allow clinicians to identify the mutations present in a patient’s tumor cells have resulted in the emerging field of precision medicine, or customized treatments based on the unique biology of an individual’s tumor. Precision medicine is an approach to disease treatment and prevention that takes into account individual variations in genes, immune function, environment, and lifestyle.

Doctors now know that each patient doesn’t just have prostate cancer, they have their own particular form of prostate cancer.

The hope is that someday, all treatment will start with genetic tests of the cancer, followed by custom treatments. Currently, there are multiple commercial tests that are approved by Medicare and select private insurance companies to better understand the aggressiveness of a tumor. Studies suggest that these tissue-based genetic tests outperform grade or stage in predicting whether a cancer is likely to metastasize. The tests are currently approved for use in select patient cases. Also on the horizon is the concept of “liquid biopsy,” where doctors can use blood tests to identify cancer mutations and treatment options.

How can you find out if you are a candidate for a precision therapy? Right now, precision medicine is an emerging field, so many treatments have limited availability. Still, a good start for anyone with metastatic, recurring, or treatment- resistant prostate cancer is to ask your doctor about precision medicine clinical trials that may be appropriate.

Another exciting area of research in prostate cancer relates to the use of immunotherapy. Historically, the problem with curing cancer has been the uncanny ability of cancer cells to reprogram themselves after treatment and hide from the immune system. The promise behind immunotherapy is that doctors are able to program the body to be smarter than the tumor, and use the immune system to kill the cancer. Numerous ongoing clinical trials are being conducted around the world trying to optimize immunotherapy to treat prostate cancer.

Today, treatments for prostate cancer include many traditional forms of cancer therapy (surgery, radiation, and/or chemotherapy) and some forms that are very specific to the prostate (hormone therapy and precision medicines in clinical trials). Remember that all treatment regimens must be balanced against quality of life concerns, with consideration given to the potential side effects of each treatment, the aggressiveness of the cancer, and the overall life expectancy of the patient.

The above blog is an excerpt from the Prostate Cancer Patient Guide, to download the complete guide click here.