James W / Tuesday, October 9, 2018 / Categories: Cancer, Innovations in Care, Patient Story Living with Prostate Cancer Genetic Testing Results in Targeted Treatment Option Prostate cancer is the most common form of cancer in men. According to the American Cancer Society, one in nine men will be diagnosed with prostate cancer during his lifetime. It is a statistic that Craig Siegel never expected he’d be among. In October 2015, while visiting his daughter, Craig experienced the urge to urinate with unusual frequency. To make sure that everything was okay, he made an appointment with Dr. Christopher Vulin, a urologist at Missouri Baptist Medical Center. “During my exam, Dr. Vulin checked my prostate and told me that it was very large and abnormal,” Craig recalled. Craig was scheduled for an immediate prostate biopsy. “Because of its size, Dr. Vulin suspected cancer,” Craig explained. “I expected I might have an enlarged prostate, but was surprised that he was worried about cancer because I hadn’t experienced any prolonged warning signs and felt fine.” After he received the biopsy results, Dr. Vulin’s suspicions were confirmed, and Craig was told that he had prostate cancer. TREATMENT OPTIONS Craig met with Dr. Paul Mehan, Missouri Baptist Medical Center oncologist and medical director of the Cancer Center. “Dr. Mehan explained that my cancer was in advanced stages with Gleason scores in the 9s and 10s,” Craig said. As defined by the Prostate Conditions Education Council, the Gleason Score is a grading system used by doctors to determine the aggressiveness of prostate cancer and helps them choose the best treatment for patients. Higher scores mean that the cancer is more likely to grow and spread quickly. “After I heard my score, I felt like I was doomed,” Craig recalled. Dr. Mehan told Craig about new clinical trial results involving chemotherapy combined with standard androgen deprivation therapy (ADT), which lowers testosterone levels that stimulate the growth of prostate cancer cells. “The treatment goal was to prolong my life, and the life expectancy of participants with similarly advanced cancer who received chemotherapy was 17 months longer than those who received standard therapy,” Craig said. After three months of treatment, Craig’s prostate-specific antigen (PSA) had lowered dramatically, and his urinary symptoms resolved. SYMPTOMS RETURN In January 2017, Craig’s PSA started to rise again. “A CT scan showed that the cancer was spreading,” Craig said. “This time, I underwent oral chemotherapy and palliative radiation to shrink the tumor and to slow the cancer’s progression. Craig continued radiation for six weeks and oral chemotherapy until early summer when his doctors discovered new metastases in his lungs and adrenal gland. GENETIC TESTING PROVIDES A TARGETED TREATMENT OPTION Craig met with Dr. Mehan again to discuss treatment options. “Dr. Mehan told me that genetic testing could identify gene mutations that might respond to targeted therapy,” said Craig. “Genetic counseling is very important,” explained MoBap’s Genetic Counselor Heidi Beaver. “For patients like Craig who are struggling with cancer, we explain the genetic basis of all cancer and what a hereditary cancer gene variant may mean to them. This allows them to make an informed decision about potential treatments, as well as options to address risk for other cancers in the future.” Genetic testing on Craig’s cancer revealed that he was a candidate for a targeted immunotherapy that had just received FDA approval. “We hoped the treatment would boost the ability of his body’s immune system to fight the cancer,” Dr. Mehan said. GLEASON SCORES FOR GRADING PROSTATE CANCER RISK GROUP GLEASON SCORE Low ≤ 6 Intermediate 7 High 8-10 The Prostate Cancer Foundation states that, usually, prostate cancer with a low Gleason score, is less aggressive. On the other hand, prostate cancer with a high Gleason score is typically more aggressive and places the patient at a higher risk for recurrence. IMMUNOTHERAPY TREATMENT During September 2017, Craig started immunotherapy through intravenous infusion. Over the following months, Craig saw his elevated PSA levels drop from 14.95 to an undetectable level of less than 0.014. Furthermore, the sites in Craig’s body where cancer had spread have normalized, and the disease is no longer evident. “He experienced a complete response in a very short time,” Dr. Mehan said. “I feel incredibly lucky,” Craig said, as he looks forward to continuing his two-year immunotherapy treatment regimen until October 2019. LOOKING TO THE FUTURE Looking back on his experience, Craig offers advice to men who might be overdue for prostate exams and seeing their physicians. “Get regular checkups and don’t forego health and cancer screenings,” he recommended. “If you are diagnosed with cancer, consider genetic testing. Now, Craig is looking forward to the future and having the opportunity to spend time with his family and pursuing his photography hobby. “Because of all the ups and downs I was undergoing, I wasn’t sure if I would be alive to see the total eclipse in 2017,” Craig added. “Now, thanks to the care of Dr. Vulin, Dr. Mehan and the entire MoBap team, I’m looking forward to photographing the next one in 2024.” WARNING SIGNS OF PROSTATE CANCER The American Cancer Society reports that early prostate cancer is usually silent with no symptoms. Signs and symptoms of more advanced prostate cancer may appear as: Problems urinating, including a slow or weak urinary stream The need to urinate more frequently, especially at night Blood in the urine or semen Trouble getting an erection (erectile dysfunction or ED) Pain in the hips, back, or chest Weakness or numbness in the legs or feet Loss of bladder or bowel control While these problems may be caused by something other than prostate cancer, talk to your health care provider if you have any of these symptoms. Print 9280 Rate this article: No rating Tags: genetic testingprostate cancer