By Admin at 19 Oct 2015, 14:29 PM

Prostate cancer is the third most common cancer in the United States. Yet despite its prevalence much about the course of the disease remains a mystery. In some men, prostate cancer lingers virtually unchanged for decades, posing no serious health threat. Many men end up dying of another cause while their prostate cancer lies dormant.

In other men, however, prostate cancer can be aggressive, spreading to the lymph nodes, liver and elsewhere in the body even after surgery. In these men, prostate cancer can quickly become deadly and urgent, aggressive treatment is often warranted.

The mystery comes in trying to decipher which cases of prostate cancer are aggressive and which are not, a mystery that increasingly appears to be solvable through the use of genetic testing.

Earlier this year researchers also published a landmark study that included a map of genetic mutations associated with lethal prostate cancers, which they called prostate cancer’s “Rosetta Stone.” The study revealed that nearly 90 percent of men with advanced prostate cancer carry such genetic mutations, which could potentially be targeted with new or existing cancer drugs.

Leonard Gomella, Chair of the Department of Urology, and Director of the Sidney Kimmel Cancer Network at Thomas Jefferson University, told Philly.com:

“We overradiate some people who don't need it and we wait too long to radiate other people … Today, most people are overtreated. We're trying to dial it back … Up until now, everything has been what you see under the microscope. This takes it beyond what you see under the microscope."

The research may also help explain why African American men are more likely than others to develop the most aggressive forms of prostate cancer. While some suggest differences in medical treatment and diagnosis are to blame, the research suggests there are also likely genetic factors at play.

The Journal of Clinical Oncology study concluded, for instance, “these [genetic] biomarkers may explain in part the biologic contribution to ethnic disparity in PC [prostate cancer] outcomes between EA [European American] and AA [African American] men.” Robert Den, a Thomas Jefferson University radiation oncologist who co-authored that study added:

"Now we can tell patients the chances of biochemical recurrence in three years, five years from surgery … We might be able to tailor postoperative treatments better, and determine the best therapy for each man."

Sources
Journal of Clinical Oncology July 20, 2015
Cell May 21, 2015
Philly.com September 14, 2015

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