ANN ARBOR, Michigan — One of the biggest challenges in treating prostate cancer is distinguishing men who have aggressive and potentially lethal disease from men whose cancer is slow-growing and unlikely to metastasize.
For years, prostate-specific antigen (PSA) level, cancer grade and tumor stage have been used to sort prostate cancer patients into risk groups established by the National Comprehensive Cancer Network. These risk groups help determine treatment course.
But the longtime practice has shortcomings.
“These risk groups were developed decades ago and were optimized for what is called biochemical recurrence, which simply means that a man’s PSA level rises again sometime after treatment,” says Daniel Spratt, M.D., associate chair of research and assistant professor in the Department of Radiation Oncology at Michigan Medicine.
“It was not optimized for more meaningful outcomes like identifying which men will ultimately develop metastases or die of prostate cancer.”
That means men with prostate cancer are being left behind in the era of precision medicine, Spratt says.
The good news? Technology has advanced to the point where genetic information derived from tissue biopsied at diagnosis can much more accurately predict which men have aggressive prostate cancer. A genomic classifier score is assigned based
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