Dr Maxwell on the Accessibility of Genetic Testing in Metastatic Prostate Cancer

Kara N. Maxwell, MD, PhD, assistant professor, medicine (hematology-oncology), Department of Medicine, Perelman School of Medicine, University of Pennsylvania, discusses the accessibility of genetic testing in the community setting for patients with metastatic prostate cancer.

In a study of patients with metastatic prostate cancer, researchers found that the real-world rates of DNA repair pathogenic germline variants were lower than previously reported. Furthermore, these rates did not show significant differences according to racial characteristics. The analysis focused on patients who underwent genetic testing through a point-of-care model at the Basser Center of Penn Medicine or through cancer genetics practices at either the VA Philadelphia Health Care or VA Greater Los Angeles Health Care.

To improve the implementation and accessibility of genetic testing, especially in community settings, several strategies can be adopted, Maxwell begins. First, there is a general awareness about genetic testing, indicating progress in this area, according to Maxwell. However, the VA setting has shown that individual nurses often bear a significant workload to facilitate genetic testing for patients. Designating a specific person whose sole responsibility is to assist patients in navigating genetic testing can greatly enhance testing efficiency and effectiveness within an oncology practice, she says. This approach is becoming more feasible as the costs of genetic testing have decreased over time, Maxwell notes.

Additionally, the Basser Center has developed a video for pre-test genetic counseling, and a similar resource was created for the VA in collaboration with the Prostate Cancer Foundation, Maxwell continues. These educational tools are crucial, as they help prepare patients for the testing process, Maxwell says. Just as prostate-specific antigen scans are routinely performed when a man is diagnosed with localized prostate cancer and bone scans are conducted for metastatic prostate cancer, genetic testing should also become a standard part of the diagnostic process, she expands.

By integrating genetic testing into the routine diagnostic workflow, health care providers can ensure patients receive comprehensive care that includes an assessment of their genetic risk factors, Maxwell concludes.