There is no question that our ability to detect prostate cancer is better than ever. But ask a man who has had an unnecessary biopsy — or two, or three, which probably means at least 36 needle sticks in his prostate, a dozen with each biopsy — and he will tell you that there is still room for improvement. “Today, the decision to biopsy is driven by abnormal findings on a digital rectal exam, or a PSA test,” says scientist Alan K. Meeker, Ph.D. Unfortunately, both of these can be abnormal even if a man doesn’t have prostate cancer; in scientific terms, they are “lacking in specificity.” Worse, although it may feel extremely thorough to the man who undergoes it, “the biopsy only samples a small portion of the prostate,” Meeker adds, “and it can miss cancer.” About one-third of men who turn out to have prostate cancer have a falsely negative result on their first biopsy. “On the other hand, many men who have a negative biopsy truly do not have prostate cancer, despite suspicious physical exam or PSA results.”

Highly dangerous, and very
common — two things, Netto
believes, that make this genetic
duo worth exploring.

Highly dangerous, and very common — two things, Netto believes, that make this genetic duo worth exploring. He is particularly interested in harnessing these fused genes as a way not only to detect which men are at risk of having a return of cancer after treatment for localized disease, but as a potential target for treatment. Ask a man who has had an unnecessary biopsy — or three, which probably means at least 36 needle sticks in his prostate — and he’ll tell you that there is still room for improvement. Using a fluorescent technology called FISH (fluorescence in situ hybridization) and another technology called tissue microarrays, which allows hundreds of microscopic tissue samples to be shown on a single glass slide, Netto can look for this fusion in normal and cancerous prostate tissue of hundreds of men with and without prostate cancer. “Studying this fusion may highlight a new target of therapy in prostate cancer patients, in the current era of emerging ‘smart drugs,’ such as those designed specifically to target the HER2 gene in breast cancer patients,” he says.