Genomic Testing for Prostate Cancer

November 10,2022 |
Man talking to his doctor.

Genomics is a term that’s used to describe the study of a person’s genes and how they’re affected by environmental factors. Although it’s related to the study of genetics, genomics is a bit different. Genetics focuses on studying genes that are inherited (nature) while genomics studies genes changed by the environment (nurture). Recently, researchers have found that new genomic testing may help individuals with prostate cancer better understand their prognosis and personalized treatment options available. To see how this could affect your diagnosis, consider the following information about genomic testing for prostate cancer.


Important Information About Prostate Cancer

The prostate is a small gland that plays an essential role in the male reproductive system. It’s responsible for the production of semen. Around your 30s, the prostate gland begins to grow and doesn’t stop until the end of your life. Although enlarged prostate (benign prostatic hyperplasia) can result in some disruptive urologic symptoms, there are treatment options available. Enlarged prostate is also not a life-threatening condition. It’s not associated with an increased risk of prostate cancer and symptoms can be reversed or managed through a variety of methods.

Prostate cancer occurs when the cells of your prostate begin to mutate and rapidly grow. Aside from skin cancer, prostate cancer is the most common form of cancer in men. Your risk increases based on genetics and ethnicity, but the prognosis is fairly optimistic. When prostate cancer is caught early, it has an extremely high curability rate. However, treatment should begin quickly to help support remission. Your doctor may recommend prostate surgery, radiation, chemotherapy, hormone therapy, or a combination of any. Prostate surgery can result in infertility, so if you’re trying to start a family talk to your doctor about available options. In some men, prostate cancer can come back after remission. Recurrent prostate cancer tends to depend on initial treatment efficacy and speed. Men over 40 should see a urologist regularly to help catch signs of prostate cancer early and reduce the risk of recurrence.


Typical Tests for Prostate Cancer

There are several tests available to help your doctor determine the presence, stage, and severity of prostate cancer. In most instances, a prostate-specific antigen (PSA) test is carried out alongside a digital rectal exam (DRE). This is standard practice for many urologists. The PSA test is a blood test that measures the amount of protein being made and secreted by the prostate ducts. When levels of PSA are elevated in the blood, it could be an indication of prostate cancer. However, this shouldn’t be used as the sole diagnostic test as there are several other factors that can increase levels of PSA within your body. For example, conditions like prostatitis and BPH can increase PSA levels, but so can riding a bicycle or having an orgasm. Doctor’s will perform a DRE to check the size of your prostate alongside the firmness, texture, and whether there are any lumps or growths present.

If your doctor feels anything abnormal during the DRE or you have elevated PSA levels with no underlying cause, you may undergo a transperineal prostate biopsy. This is a straightforward biopsy procedure that can accurately diagnose the presence of prostate cancer. If you have any questions about undergoing a biopsy, talk to your urologist ahead of time.


Understanding Genomic Testing for Prostate Cancer

Another potential testing option is genomic testing. Although genetics is an important part of understanding your risk for prostate cancer, recent studies have begun to better understand risk factors outside of inheritance. Genomics, therefore, can play an important role in understanding how prostate cancer and associated tumors may act. Genomic testing may also provide information on the behaviors of cancer genes present.

Genomic testing can be used to understand early-stage or localized prostate cancer. It can also give men an indication of their future risk of developing prostate cancer. However, there are some limitations in genomic testing, so it should not be viewed as 100% reliable. Genomic testing can provide you with a general understanding of your current cancer or your future risk. Genomics can also help your doctor understand if your cancer is likely to spread, the speed at which it could progress, and how to best monitor and treat the type of cancer. It should be used in conjunction with other diagnostic tests and the continual monitoring of cells for signs of change or growth.


Different Types of Genomic Testing

There are several different types of genomic testing. Which options your doctor recommends will be based off of your biopsy results. If you have elevated PSA levels or your doctor believes that a biopsy is in order, but your results come back negative for cancer, there are two different genomic tests that they may recommend: ConfirmMDx or Progensa.

ConfirmMDx and Progensa

Both of these genomic tests are used to confirm a negative test and requires no additional samples from you. They test the tissue that was already gathered and biopsied. These tests may be able to indicate whether or not your prostate cells will change into cancer at some point during your life. They’re a good option to avoid repeated biopsies as they can also confirm a previous negative test to provide more peace of mind.

Prostate cancer can also present itself in different forms and degrees of severity. If you undergo a biopsy and your results showed a presence of cancer, your urologist may want to run further tests to better understand which treatment option to take. Since some forms of prostate cancer only require active surveillance while others should be approached with chemotherapy and surgery, these genomic tests may help you find the best course of action for your circumstances. The genomic tests available for this include Prolaris, Oncotype Dx, ProstaVysion, and Decipher Prostate Biopsy.

Prolaris, Oncotype Dx, ProstaVysion, and Decipher Prostate Biopsy

All of these genomic tests test the same thing and have the same overall function. These also use the previously biopsied tissue for further tests, making them easy and worth the additional lab processing. They’re used to help determine whether you should treat prostate cancer using active surveillance or a more invasive form of treatment. They’re essentially different variations of the same genomic test, which provides information about the speed at which your prostate cancer may grow or the likelihood it is to metastasize and spread to other parts of your body.  

The last type of genomic testing for prostate cancer is done in individuals who have had their prostate cancer removed surgically, through a radical prostatectomy. These genomic tests are used to determine whether or not further treatment (i.e., radiation, chemotherapy, hormone therapy) should be used. They include Prolaris, Decipher, and PORTOS.

Prolaris and Decipher

These two genomic tests are also used to determine how fast the cancer may spread or grow and may shed light on the risk of prostate cancer recurrence. They use the prostate tissue that was removed during the prostatectomy for testing.


This genomic test offers a little more information. It provides your urologist with insight regarding how you may respond to additional treatments. This can help you determine whether or not radiation therapy is worth pursuing, or if active surveillance following surgery is preferred. Since certain treatment options can have long-lasting side effects, it’s important to weigh your options based on your lifestyle and personal evaluation of risks. Your doctor will go over all of these details with you during pre- and post-op.

There are several genomic tests available today, but some people may benefit from undergoing them more than others. The best way to determine if this is an option you should pursue is to talk to your urologist. Seeing your urologist yearly is a proactive way to make sure that you’re staying healthy and addressing any problems early on. It’s also an important part of early detection for prostate cancer. Although it’s safe for most men to begin these appointments around the age of 40, you should go earlier if you suffer from symptoms of any urologic conditions or have a family history of prostate cancer. If you need any urologic supplies or additional educational resources, visit our educational support page or our urology product selection guide. Byram Healthcare is proud to offer full-service urologic care with the high-quality urologic supplies that you need. If you need to order any urologic supplies, your packages can be discreetly delivered to your home, at any time of the day.