You choose, we deliver
If you are interested in this story, you might be interested in others from The Journal Gazette. Go to www.journalgazette.net/newsletter and pick the subjects you care most about. We'll deliver your customized daily news report at 3 a.m. Fort Wayne time, right to your email.

Health

  • Popular uterine surgery may heighten cancer risk
    The Food and Drug Administration is warning doctors against using a popular method to remove the uterus or uterine fibroids without open surgery because it can spread cancer cells.
  • 3rd chromosome 21 at work
    Symptoms of Down syndrome are produced by gene impairments across every chromosome, not just one, according to a study that may bring new understanding to the most common genetic cause of intellectual disability.
  • Heart attacks, strokes declining for diabetics
    In the midst of the diabetes epidemic, a glimmer of good news: Heart attacks, strokes and other complications from the disease are plummeting.
Advertisement

Gene test billed as prostate cancer aid

A new genetic test to gauge the aggressiveness of prostate cancer may help tens of thousands of men each year decide whether they need to treat their cancer right away or can safely monitor it.

The new test, which goes on sale today, joins another one that recently came on the market. Both analyze multiple genes in a biopsy sample and give a score for aggressiveness, similar to tests used now for certain breast and colon cancers.

Doctors say tests like these have the potential to curb a major problem in cancer care – overtreatment. Prostate tumors usually grow so slowly, they will never threaten a man’s life, but some prove fatal, and there is no reliable way now to tell which ones will.

Treatment with surgery, radiation or hormone blockers isn’t needed in most cases and can cause impotence or incontinence, yet most men are afraid to skip it.

“We’re not giving patients enough information to make their decision,” said Dr. Peter Carroll, chairman of urology at the University of California, San Francisco. “You can shop for a toaster” better than for prostate treatment, he said.

The study he led of the newest test – the Oncotype DX Genomic Prostate Score – is set for discussion today at an American Urological Association meeting.

The results suggest the test could triple the number of men thought to be at such low risk for aggressive disease that monitoring is a clearly safe option.

Conversely, the test also suggested some tumors were more aggressive than doctors had believed.

Independent experts say such a test is desperately needed but that it’s unclear how much information this one adds or whether it will be enough to persuade men with low-risk tumors to forgo treatment, and treat it only if it gets worse. Only 10 percent who are candidates for monitoring choose it now.

“The question is, what’s the magnitude of difference that would change the patient’s mind?” said Dr. Bruce Roth, a cancer specialist at Washington University in St. Louis.

One man may view a 15 percent chance that his tumor is aggressive as low risk, “but someone else might say, ‘Oh my God, let’s set the surgery up tomorrow,’ ” he said. “I don’t think it’s a slam-dunk.”

Also unknown: Will insurers pay for the expensive test without evidence it leads to better care or saves lives?

Advertisement