Very Personal Medicine

While PSA testing remains the gold standard for predicting cancer risk, and the cancer's appearance under the microscope remains the best way to guess how it will behave, researchers are convinced that ongoing biomarker research and genetic analyses will lead to significant improvements in prostate-cancer detection and treatment. Each individual could have a panel of tests: one for diagnosing the cancer, a second to determine if the cancer needs to be treated and a third to determine the best treatment. That's what the hope of "personalized medicine" is all about.

Molecular studies designed to improve diagnosis and judge who needs treatment may also point to effective new therapies based on genetic studies. Massimo Loda at Harvard's Dana-Farber Cancer Institute has found that the fusion of two genes greatly increases the risk that prostate cancer will return and prove fatal. In other cancers, the discovery of such fused genes has led to powerful new treatments. Lewis Cantley and Pier Paolo Pandolfi at Harvard's Beth Israel Deaconess Medical Center are studying drugs that might enhance one gene that keeps cancers in check, as well as different drugs that inhibit a second, cancer-promoting gene. Whether or not this specific approach proves successful, most experts believe that today's molecular technologies will revolutionize the diagnosis, prognostication and treatment of prostate cancer. It's not a question of if, but when.

Garnick and Rose edit Harvard Health Publications' Perspectives on Prostate Disease. Garnick is also clinical professor of medicine at Harvard Medical School and an oncologist at Beth Israel Deaconess Medical Center. For more on prostate disease, go to health.harvard.edu/newsweek.

© 2008