Prostate cancer is one of the most common cancers in men, with over 191,000 new cases diagnosed in the United States in 2020 alone.

The majority of men diagnosed with prostate cancer will have a favorable prognosis, but some will go on to develop aggressive cancer that requires aggressive treatment. Genetic testing is one tool that is being used to help predict which men will have aggressive prostate cancer, which can help guide treatment decisions.

What is Genetic Testing?

Genetic testing is a laboratory test that analyzes DNA to look for changes in specific genes that may be associated with certain diseases or conditions.

In the case of prostate cancer, genetic testing can help identify men who are at increased risk for aggressive prostate cancer.

There are several different types of genetic tests that can be used in prostate cancer:.

Germline genetic testing

Germline genetic testing looks for inherited changes in genes that increase the risk of developing prostate cancer. These changes are present in every cell of the body and can be passed down through families.

BRCA1 and BRCA2 are examples of genes that have been linked to an increased risk of aggressive prostate cancer. Men who carry these mutations may benefit from more aggressive screening and treatment.

Tumor genetic testing

Tumor genetic testing looks for changes in DNA that are specific to the cancer cells. This type of testing can help identify genetic mutations that are driving the growth of the tumor and may be targeted with specific therapies.

Tumor genetic testing is typically done on a tissue sample taken during a biopsy or surgery.

What Can Genetic Testing Tell Us About Prostate Cancer?

Genetic testing can provide important information about a man’s risk of developing aggressive prostate cancer and can help guide treatment decisions. Here are some of the things that genetic testing can tell us:.

Risk Assessment

Germline genetic testing can help identify men who are at increased risk of developing prostate cancer. This information can be used to develop a screening and surveillance plan that is tailored to the individual’s risk.

Treatment Selection

Tumor genetic testing can help identify genetic mutations that are driving the growth of the tumor. This information can be used to select targeted therapies that may be more effective in treating the cancer.

For example, men with mutations in the BRCA1 and BRCA2 genes may benefit from PARP inhibitors, which are drugs that target a specific pathway that is disrupted in these mutations.

Prognosis

Genetic testing can also help predict a man’s prognosis and likelihood of developing aggressive prostate cancer.

For example, men with mutations in the PTEN gene have been shown to have a higher risk of developing aggressive prostate cancer that is resistant to treatment.

Limitations of Genetic Testing

While genetic testing can provide valuable information about a man’s risk of developing prostate cancer and guide treatment decisions, there are some limitations to this technology.

Cost

Genetic testing can be expensive, and not all insurance plans cover the cost of testing. This can be a barrier for some men who may benefit from genetic testing but cannot afford it.

Interpretation

Interpreting the results of genetic testing can be complex. Many genetic mutations are rare and may not have a clear association with prostate cancer.

Understanding the significance of a genetic mutation requires expertise in genetics and prostate cancer.

False Positives and False Negatives

Genetic testing is not 100% accurate. False positives and false negatives can occur, which can lead to unnecessary treatment or a false sense of security.

Conclusion

Genetic testing is a promising tool that can help predict a man’s likelihood of developing aggressive prostate cancer and guide treatment decisions. However, there are limitations to this technology that must be understood and considered.

As the field of genetics continues to advance, we can expect that genetic testing will play an increasingly important role in the management of prostate cancer.