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Treating Prostate Cancer: Drilling Down with Genetics to Better Assess Risk

Wednesday, April 24, 2019 1:48 PM

A prostate cancer diagnosis can create a difficult dilemma for men. The disease is the second-leading cause of cancer death in American men, behind lung cancer. But not all prostate cancers are created equal. Many men have a less aggressive form of the disease and can live with it for years without treatment or invasive surgery. 

Brian Kibitlewski of Grayslake experienced this predicament firsthand a couple of years ago after a routine prostate-specific antigen (PSA) blood test. The result revealed an elevated PSA score, which can be a strong indicator of cancer by measuring a protein exclusively produced in the prostate.

Decisions Ahead
In search of guidance, Kibitlewski turned to the experienced team at NorthShore’s John and Carol Walter Center for Urological Health, where he met with Brian Helfand, MD. Dr. Helfand is a leading prostate cancer researcher and clinician and holds the Ronald L. Chez Family and Richard Melman Family Chair of Prostate Cancer.

“The great challenge for us as physicians is to distinguish the benign from the more aggressive forms of the disease that will most likely spread and can be lethal,” explained Dr. Helfand, who holds an academic appointment at the University of Chicago Pritzker School of Medicine.

Dr. Helfand performed a biopsy that confirmed Kibitlewski had prostate cancer, but left the 58-year-old at a pivotal crossroads. Should he follow a course of so-called “watchful waiting,” where his caregivers closely monitor the disease without treatment, or should the husband and father of two take more aggressive action? Kibitlewski’s father also had been diagnosed with prostate cancer but did not die from the disease. 

“It’s a very difficult decision to make,” recalled Kibitlewski. “You don’t want to do nothing, but having your prostate removed is no picnic, either.”

The Role of Genetics
Physician-scientists at NorthShore’s Mark R. Neaman Center for Personalized Medicine are working feverishly to better identify which prostate cancer patients are at the greatest risk. Through genetic testing, they are drilling deeper to better understand the DNA of prostate cancer and creating new tools to more accurately assess a patient’s risk.

For further validation, Dr. Helfand encouraged his patient to take the NorthShore-developed Genetic Risk Score test in a clinical trial led by his colleague Jianfeng Xu, DrPH, Vice President of Translational Research and the Ellrodt-Schweighauser Family Chair of Cancer Genomic Research.

The screening, developed through research funded in part by generous donations to NorthShore Foundation, uses predictive genetic tests to better assess the risk of not only prostate cancer, but also breast and colorectal cancer. For Kibitlewski, the risk score suggested he most likely developed the disease through genetic inheritance.

Leading the Charge in Genetic Innovation
“The Genetic Risk Score confirmed what Dr. Helfand anticipated,” recalled Kibitlewski. “It also gave me another source of information and provided confirmation that I was making the right decision in having my prostate removed.”

Dr. Helfand performed the minimally invasive surgery more than a year ago, and Kibitlewski has since fully recovered and is feeling good. He is thankful to have had the knowledge to act before a potentially aggressive cancer had the opportunity to spread.

“I’m grateful to be at a place like NorthShore, where I can take advantage of groundbreaking tools, and also to have Dr. Helfand to help me think this through,” emphasized Kibitlewski. “He was great. He didn’t pressure me either way, but helped me work through it and make a decision.”

Looking Out for His Family 
Kibitlewski also is taking it one step further by sharing his own experience with his five brothers. He has encouraged them to be proactive about their prostate health and investigate any genetic link. “They need to stay ahead of any potential health problems with regular screenings and checkups,” he added.

“This test can be life-changing for patients and their family members,” said Dr. Helfand. “The opportunity to screen for select gene mutations well before traditional diagnostic testing is a very exciting advancement that we’ve been a part of here at NorthShore, and one that’s making a difference for patients like Brian.”