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Considering Genetic Testing in Patients With Prostate Cancer

Leonard G. Gomella, MD
Published Online:8:00 PM, Tue November 5, 2019

Leonard G. Gomella, MD, professor, chair, Department of Urology, and director, Sidney Kimmel Cancer Center Network, Thomas Jefferson University Hospital, discusses the factors that determine which patients with prostate cancer should undergo genetic testing.

The National Comprehensive Cancer Network (NCCN) guidelines state that any patient with multiple family members who are under the age of 55 with prostate cancer should consider getting genetic testing, says Gomella. Additionally, for patients with a heavy burden of other cancers, such as breast cancer, ovarian cancer, melanoma, or pancreatic cancer in the family, or those with hereditary cancer syndromes, they should also consider testing.

Gomella says the least controversial area in genetic testing currently is for the testing of men who present with metastatic prostate cancer as the disease could be inherited. PARP inhibitors, a new class of drugs, will soon be introduced to this space, a treatment that will be driven by genetic testing results.

According to Gomella, over 80% of patients with prostate cancer have what is called sporadic prostate cancer. These cancers cannot be associated with an inherited or familial clustering of cancer. However, genetic testing is important to consider to find the 15% to 20% of men where there is a genetic connection.
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