Using genetics to personalize prostate cancer

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Using genetics to personalize prostate cancer

Men diagnosed with prostate cancer usually have several options to choose from for treating it.  But someday a much better option may be available of using a man’s genes to be the determinant of guiding prostate cancer treatment.

Generally, the majority of prostate cancers are localized, meaning they have not spread beyond the confinements of the prostate gland.  In this scenario, doctors may advise on how to treat it based on the cancer’s status.  This could include active surveillance, surgery or radiation.  However, if the cancer has spread outside the prostate, androgen deprivation therapy (ADT) is often the first choice.  

Androgen deprivation therapy, also known as hormone therapy, involves reducing the flow of male hormones (androgens), especially testosterone, in the body.  Since these hormones are like fuel for the fire promoting the growth of the prostate and of prostate cancer, depriving the body of androgens usually slows the progression of the cancer.  ADT is normally used to combat prostate cancer when it has recurred following surgery or radiation, is advanced, or for patients whose prostate cancer has spread. 

Finding more effective treatment

Even though ADT can be effective, the problem with ADT is it becomes less effective long-term as cancer cells eventually find a way to produce their own androgens.  Eventually the cancer learns how to outsmart the treatment and will almost always return after several months or a few years.

Due to the fact ADT is limited on its ability to keep prostate cancer from returning, scientists have turned to searching for more innovative, sustainable methods to prevent a tumor from spreading. They have been searching for more personalized therapies that are more likely to result in a better outcome long-term.

An exciting bit of news is that recent research has discovered that the effectiveness of ADT is shortened for men who have a specific variant of a specific gene – the HSD3B1 gene. Men have two copies of this gene, one from each parent. Some men inherit the normal version of the gene while others get the variant gene from one parent and others get it from both parents.  Men who have the gene from both parents are more likely to have their prostate cancer recur sooner.

What researchers discovered working in this field of personalized medicine using gene therapy is that when comparing a tumor from one patient to a tumor from a different patient, the genetics which is what drives tumor progression, is quite different.  Basically, two different men with prostate cancer will not have the same type of prostate cancer because of their individualized genetic makeup.  Because of this fact, this is the direction scientists believe needs to be taken to look closer at genetic biomarkers for guiding more effective prostate cancer treatment.

The eventual goal of treating not only prostate cancer but all types of cancers is to move beyond a one-size-fits-all treatment mentality.  Everyone with cancer responds differently to the various treatments offered.  By discovering each individual patient’s genetic makeup and working towards more personalized treatments, this could be a huge breakthrough in finally figuring out the very best way to treat prostate cancer for each unique man diagnosed with this disease.