If you have cancer, is genomics right for you? 4 things every patient should know

Stock image, St. George News

FEATURE — Genome sequencing – or genomics – is a process that analyzes an individual’s DNA and looks for mutations or alterations that contribute to cancer and other diseases. This technological advancement in medicine can lead to better diagnoses and therapies, but some experts say genome sequencing might not be appropriate for every patient.

Dr. Joseph Te, a hematology-oncology specialist with Revere Health Cancer Center, said there are four things cancer patients should be aware of before making the decision to pursue genome sequencing.

Genome sequencing is the test, not the treatment.

“A lot of patients see information about genomics through advertisements, and I think there’s some perception out there that it’s a treatment,” Te said.

In reality, genome sequencing is only a test that gives health care providers more information about treatments that are available for the patient. Those tests can be beneficial in choosing which therapy to provide, but there is no guarantee that the therapy will work.

The need for genomics is on a case-by-case basis.

Certain types of cancers respond well to traditional cancer treatment, and there is sufficient evidence to support its effectiveness. In these situations, genome sequencing usually isn’t necessary.

Image courtesy of Revere Health, date and location unspecified | St. George News

“Hodgkin’s lymphoma, for example, is a very curable disease,” Te said. “In a normal setting we wouldn’t need to do genome sequencing because we know that the standard treatment is extremely effective, but it really does depend on the case.”

Genome sequencing is typically best for patients who have a mutation that may respond to targeted therapy, a treatment that interacts with specific characteristics of cancer cells rather than all the cells in the body.

An oncologist can help patients evaluate their unique situation to determine whether genome sequencing is appropriate.

Genome sequencing may not be covered by insurance.

Medicare announced earlier this year they would cover FDA-approved tests for advanced cancer patients. Commercial insurance providers may provide coverage for these tests only if there is sufficient evidence to support a need for it.

Te also explained the field of genomics is still in its infancy, and because a lot is still in experimental stages, many of the targeted therapies are not yet approved by the FDA.

“A good example is prostate cancer. There are very few FDA-approved targeted therapies to treat this type of cancer, and those targeted therapies work if your tumor contains the exact mutation that responds to that therapy,” Te said. “It’s possible a patient will present mutations that respond to targeted therapies approved for the treatment of breast or lung cancer, but there’s no data on how it will affect prostate cancer.”

Patients and their doctors can still choose to use targeted therapies approved for other types of cancer, but most patients will have to pay for that therapy out of their own pocket. Some of those drugs can cost thousands of dollars each month without insurance coverage.

Patients have the right to choose.

Every person is different. Some people may experience fewer side effects with targeted therapy, but other people may experience severe side effects and prefer traditional cancer treatment.

“I give them data about the standard, FDA-approved treatment but let them know that there are other options. It’s also important that the patient understands the financial and health aspects of each option,” Te said, adding he always has a discussion about genomics with his patients.

Genome sequencing has been proven to work but not in every patient. Te explained the majority of patients will turn to it as a last resort if other standard treatments are unsuccessful or if there aren’t any treatment options available. Insurance may cover testing and potentially treatment in these cases.

“The future of cancer treatment is genome sequencing,” Te said, “but we should be realistic about the current limitations and hope the science continues to improve and save lives.”


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