Genomic Testing & Biomarkers

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Genomic testing

As a cancer forms, changes and grows, alterations in the genetic material (DNA and genes) in the cancer cells often occurs. Genomic testing looks at these changes. This is different to genetic testing which looks at the genes and DNA you were born with (inherited from your parents).

If you have had a prostate biopsy or a prostatectomy (surgery to remove your prostate), samples taken from your prostate can be used for genomic testing. The results of this test may help predict how quickly your cancer is likely to grow and spread. This can assist you and your doctor to decide the best course of treatment for you.

Why is genomic testing used?

Genomic testing can be used to look at the genetic make-up of your prostate cancer to help predict if your cancer is likely to grow quickly or spread. This is different to prostate cancer grading that uses the Gleason Score or ISUP Grade.

Genomic testing is most helpful when you have been newly diagnosed with prostate cancer and the disease is localised (has stayed within your prostate), as it can help establish your cancer’s risk level and guide treatment options for you.

What risk levels can genomic testing predict?

Genomic testing can help predict: 

  1. Low-risk prostate cancer – unlikely to grow or spread for many years
  2. Medium-risk prostate cancer – unlikely to grow or spread for a few years
  3. High-risk prostate cancer – may grow or spread within a few years

Knowing the risk level of your prostate cancer can help your doctor decide if treatment is necessary and what treatments are available to you.

What are biomarkers?

Biomarkers are genes, proteins or other cancer markers found in your body fluids, such as urine, blood and semen, and in your body tissue or within the cancer. They can be used in tests to identify if you have abnormal cell activity or disease.

Why is testing using biomarkers done?

Biomarker testing can help with prostate cancer detection and diagnosis and can guide your doctor in deciding the best treatment options for you.  This is called personalised or precision medicine and is relatively new to prostate cancer. Find out more at What is precision medicine? 

Biomarker testing can:  

  • Assist with detecting cancer
  • Identify more aggressive (fast growing or spreading) disease
  • Help guide the best treatment decisions for you 
  • Help to monitor cancer during and after treatment

One of the biomarkers used now is a protein called Prostate Specific Antigen (or PSA), which helps detect prostate cancer. This is called a biological marker. Read more about PSA testing. 

Other biomarker testing looks for certain gene mutations that may affect the growth or spread of your cancer, telling you how aggressive your cancer might be. This is genomic testing, which is also called molecular testing or profiling.

It is important to remember that genomic and biomarker testing are not the same as genetic testing, which only looks for inherited genes (genes passed down from your parents). 

Follow the links to learn more about genetic testing:

Genetic Risks & Testing

Genetic Testing & Counselling

If you need more information on genomic or biomarker testing, talk to your doctor or reach out to a PCFA nurse.

Key points

  • Genomic testing identifies changes in genes in prostate cancer tissue.
  • Genomic testing can help predict whether your cancer is low or high-risk and helps guide treament options.
  • Biomarkers are genes, protein and other cancer markers. 
  • Biomarker testing may be used to help diagnose prostate cancer, identify cancer risk and provide more personalised treatment options.
  • PSA is a biological biomarker; gene mutations are molecular biomarkers.
  • Emerging and future research may make more of these tests routinely available.