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Test and Watch, Watch and Test

Genetic tests are helping clinicians determine whether a prostate tumor is aggressive and needs to be treated or is indolent and should be warily watched, the Wall Street Journal reports.

For instance, when 70-year-old Al Piazza learned he had prostate cancer, he first just wanted the tumor out, as he tells the Journal. But his doctor, Jeremy Lieb, noted that the side effects of treating prostate cancer sometimes are worse than the disease itself, and he instead suggested testing Piazza's tumor using Myriad Genetics' Prolaris. The test indicated that Piazza only had a 3 percent chance of dying from that tumor in the next 10 years, and because of that, Piazza and Lieb are now just monitoring his cancer.

Myriad, the Journal adds, isn't the only company getting into of sorting out tumors that need to be dealt with from ones that are likely harmless. MDxHealth's SelectMDx examines urine samples for gene fragments from prostate cancer to gauge its risk level, while Exosome Diagnostics is about to launch a test that looks for exosomes. At the same time, Genomic Health's OncotypeDx examines a set of genes to predict whether or not the tumor may metastasize, and MetaMark Genetics' ProMark test evaluates tumor protein biomarker levels to determine its aggressiveness.

"It's very exciting to have these tests available, but it's sort of the Wild West now," Scott Eggener, a University of Chicago urologist and a spokesman for the American Urological Association, tells the Journal.