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Individualized Prostate Cancer Care: Q&A with an Expert

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How does individualized medicine target treatments to a particular patient’s needs and genes? And does it guarantee successful results? H. Ballentine Carter, M.D., director of the Prostate Cancer Program at Johns Hopkins Medicine, breaks down the basics of individualized medicine and explains why it’s important for prostate cancer care.

Q. Is individualized prostate cancer care a new concept?

A. No, individualized, or personalized, medicine is not a new concept. As doctors, our goal is always to match the right type of treatment (or disease management strategy) to the right patient at the right time.

However, what is new is the ability to use different measurements to track how large numbers of patients react to treatments and disease management strategies. We can then identify subsets of patients who respond to treatment in a particular way.

Q. How—and why—do doctors target prostate cancer treatments?

A. In individualized medicine, we use that information to guide—or target—our treatment recommendations. It’s about figuring out the odds and playing them well.

Imagine a group of patients who all have similar symptoms. However, their diseases may be very different. Diseases that present similarly may require very different management options.

With the data available through modern technologies, doctors have a better idea of what distinguishes one individual from another, even though they may have similar symptoms. For example, with testing options available today, doctors can now:

  • Analyze a patient’s genetic makeup.
  • Analyze the expression of genes, which seeks to learn more about your genes from a cellular level and uncover how they interact with certain diseases.
  • View the protein makeup of tumor tissues.

All this information helps doctors form a more targeted approach in how they treat or manage a disease. In individualized medicine, doctors may recommend certain treatments that are specifically targeted to your (or any patient’s) needs. This could be based on your:

  • Genes
  • Biomarkers, or biological measures such as urine or blood, which can indicate severity or presence of a particular disease state
  • Physical characteristics
  • Psychosocial characteristics

Q. Why is individualized care in prostate cancer important?

A. Diseases are heterogeneous, which means any cancer (breast cancer, for example) is not one disease but many diseases. Prostate cancer is a perfect example.

If we gave everyone with prostate cancer the same treatment, we’d end up with:

  • Unnecessary treatments
  • Ineffective treatments
  • Unnecessary side effects

Individualized medicine attempts to break down a particular disease into different subtypes by looking at how groups of patients respond to certain treatment options. This allows us to target a management technique that works for a certain subset of disease and deliver it to the right patients.

Individualized medicine doesn’t guarantee success, but it does increase the odds of success. As doctors, we want to increase the likelihood that a patient will benefit from a particular treatment. Individualized medicine can help us play the odds better, thus improving health outcomes.

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