In this video, an expert discusses which men with prostate cancer are eligible for genetic testing, and what patients can do if they are not eligible but want to undergo testing anyway.
It is important that patients with prostate cancer work with their providers to determine if they should undergo genetic testing, explained Dr. Veda N. Giri, a professor of medical oncology, cancer biology and urology at the Sidney Kimmel Cancer Center at Thomas Jefferson University in Philadelphia.
In the case of prostate cancer, genetic testing guidelines focus on the likelihood of finding a mutation, as well as if testing results could change the treatment plan.
“Those men (who) have metastatic prostate cancer would be recommended to consider genetic testing,” Giri said in an interview with CURE®. “We could open doors for new treatments for them, potentially clinical trials and certainly hereditary cancer syndromes in their families.”
Giri explained that men with localized prostate cancer with high-risk features should also consider genetic testing, as well as men of Ashkenazi Jewish decent, as there is a high prevalence of the BRCA mutation in this population.
Even if patients are not eligible for genetic testing, they can still advocate for undergoing the tests, and pay out of pocket — something that typically costs about $250, according to Giri.
It's important, certainly, for certain subsets of patients to think about genetic testing; it still comes down to making an informed decision for genetic testing.
So really, the guidelines are focused on patients where there's a high likelihood of finding genetic mutations, or where it could really impact their treatment of their cancer, management of cancer or screening for cancers. So certainly … if we're talking about for prostate cancer patients, those men (who) have metastatic prostate cancer would be recommended to consider genetic testing for the reasons that we mentioned. We could open doors for new treatments for them, potentially clinical trials and then certainly hereditary cancer syndromes in their families.
Even patients (who) have high risk, if it's a localized prostate cancer, that's with high risk features, they are also recommended to have genetic testing, because of the higher chance of finding a genetic mutation in those individuals, and also being able to think about the hereditary cancer implications in their families.
Knowing the family history is also really important. So patients (who) have a strong family history of cancers, not only just prostate cancer, but also cancers in males and females such as breast cancer, ovarian cancer, uterine cancer, colon cancer, pancreatic cancer, both on the male side of the family, the paternal side of the family, and the maternal side of the family would be really important to think about because those patients could qualify for genetic testing as well, because of the strong family history. Also men (who) have prostate cancer, if they're of Ashkenazi Jewish ancestry should really also consider their own genetic testing because have the higher rates of specific mutations in certain populations, such as higher rates of BRCA mutations in patients of Ashkenazi Jewish ancestry.
So, there are a lot of criteria that helped to identify which patients should really consider genetic counseling and genetic testing.
Really, even if a patient is highly motivated and doesn't strictly meet criteria, they really can still meet with a genetic counselor, and if they are interested in proceeding with their own genetic testing, after hearing the making an informed decision, they could pay out of pocket for genetic testing. Typically, that out-of-pocket cost these days is about $250 or less. So that can be affordable for some patients and, you know, might lead the more motivated patients to think about testing even if they don't meet national guidelines.
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