1. Prostate Cancer Management: A Guide for Patients and Caregivers
Oncotype DX® Prostate Cancer Assay:
The Role of Genomics In Your Decision-Making
Is Active Surveillance Right For You?
Prostate Cancer Management: A Guide for Patients and Caregivers
GHI40101_0914 1

2. Topics we will address today…
Prostate Cancer Basics
Understanding Your Treatment Options
Active Surveillance
Oncotype DX® Test Overview
Additional Resources for Patients
Next Steps

3. Prostate cancer basics
What you and your loved ones need to know:
MOST
SOME
1 in 6
Prostate Cancer Facts You & Your Loved Ones Need to Know
Reference:
Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, CA Cancer J Clin Jan-Feb;64(1):9-29.
Patient Education Brochure
men will be diagnosed with prostate cancer during their lifetime
prostate cancers are aggressive and higher risk
prostate cancers
are not aggressive
and lower risk (favorable pathology)

4. Low-risk prostate cancer is often over-treated
90%
OF MEN RECEIVE
IMMEDIATE TREATMENT
YET ONLY 3%
ARE AT RISK OF PROGRESSION & DEATH
Reference:
Patient Education Brochure
Prostate Sales Aide
Grey bar represents 10% of patients who receive Active Surveillance

5. A doctor’s perspective
“We desperately need the ability to predict which patient has a localized cancer that is going to metastasize and cause suffering and death, and which patient has a cancer that is destined to stay in the patient's prostate for the remainder of his life.”
 -Otis W. Brawley, MD
Chief Medical Officer
American Cancer Society
Reference
Graff St. Overdiagnosis Since Introduction of Prostate Cancer Screening. JNCI J Natl Cancer Inst (2009) 101 (19): 1293.

6. Understanding your treatment options
IMMEDIATE
TREATMENT
ACTIVE
SURVEILLANCE* OR
Potential Benefits
Men may be cured if:
Tumor has not spread
All cancer is removed
Radiation kills all the cancer
Potential Risks
Urinary incontinence
Erectile dysfunction
30-40% chance of recurrence
Use of a catheter for 1-2 weeks
Bowel control issues or rectal bleeding (for radiation)
Potential Benefits
Maintains window of cure
Allows men with low-risk cancer to:
Closely monitor their cancer
Live out their entire lives without surgery or radiation
Avoid the side effects associated with surgery and radiation
Potential Risks
Slight risk that cancer may grow and spread
With a schedule of close monitoring it should be caught before it spreads
SURGERY
Reference:
Patient Education Brochure
RADIATION
*Includes biopsy; DRE (Digital Rectal Exam), PSA (Prostate-Specific
Antigen) testing, and MRI (Magnetic Resonance Imaging)

7. What is Active Surveillance?
A program of closely monitoring and following your
prostate cancer avoiding surgery or radiation.
Periodic examinations may include*:
PSA Testing
Digital Rectal Exam (DRE)
Surveillance Biopsy
Magnetic Resonance Imaging(MRI)
If any changes are detected your doctor may recommend additional treatment
Reference:
Patient Education Brochure
* Timing and frequency of these examinations will be specified for you by your doctor

8. Who is eligible for Active Surveillance?
Up to HALF of men with low risk cancer could be candidates for
Active Surveillance
Reference:
Klotz L1. Emberton M. Management of low risk prostate cancer: active surveillance and focal therapy. Curr Opin Urol May;24(3):270-9.
Your doctor will assess your clinical risk
(an estimation of your cancer's aggressiveness)
to confidently recommend Active Surveillance

9. 10+ years of genomic experience
is a leading provider
of genomic cancer diagnostic tests:
Available TODAY
The Oncotype DX Test - 10 Years and Beyond
Over the past decade, Genomic Health has redefined personalized medicine through the innovation of Oncotype DX, making genomics an indispensable part of breast, colon and prostate cancer diagnosis and treatment. In its next decade, Genomic Health aims to lead the transformation of cancer into a manageable disease with the goal of reducing the high toll of cancer on both the individual and society. In this way, Genomic Health will continue to shape a world in which genomic information is truly life, changing.
2004
2010
2013

10. Principles of genomics
Genomics examines groups of genes and their relationships in order to identify their combined influence on your cancer’s behavior*
Oncotype DX® assay evaluates genes for:
Cell division
Cell organization
Cell aggressiveness
Reference:
Prostate Sales Aid
*At time of diagnosis

11. The Oncotype DX® test provides personalized information
Predicts the UNIQUE BIOLOGY of your tumor based on biopsy tissue
Examines the expression of a panel of GENES associated with prostate cancer pathology and progression, a science known as “genomics”
Reference:
Patient Education Brochure
Provides a more specific and PRECISE
risk assessment than clinical risk alone

12. Quick facts about Oncotype DX® Prostate Cancer Assay
GPS
Who is the test for?
What is the Genomic Prostate Score (GPS)?
What is Favorable Pathology?
Reference:
Patient Education Brochure
Patients with
very low to
low-intermediate risk disease
Your Oncotype DX® results are reported as a GPS, that when combined with other clinical factors, can further clarify your risk
Confirmation that the tumor is low risk and fully confined to the prostate

13. Oncotype DX® along your prostate cancer journey
SCREENING
PSA
DRE
DIAGNOSIS
Biopsy
Gleason
Stage
TREATMENT
DECISION
Active Surveillance OR
Immediate Treatment
Reference:
Patient Education Brochure
It is a genomic test that gives you and
your doctor confidence to choose
the best management plan for your cancer

14. GPS helps provide a precise risk assessment
VERY LOW
INTERMEDIATE
LOW
Reference:
Patient Education Brochure
Likelihood of favorable
pathology
100
More favorable
Less
favorable

15. Know your score. Know your risk.
The LOWER YOUR GPS,
the more favorable your tumor biology, and the more likely you can safely consider Active Surveillance
The HIGHER YOUR GPS,
the less favorable your tumor biology, and the more likely that you should consider Immediate Treatment
Reference:
Patient Education Brochure

16. A patient’s perspective Choose with confidence
“I was determined to educate myself about all of my options, and thanks to Oncotype DX®, I confidently chose Active Surveillance based on my GPS result.”
-Dan W.
Oncotype DX®
Prostate Cancer
Patient Ambassador
Your Prostate, Your Decision: A Patient's Perspective
A prostate cancer patient shares his story to help raise awareness that men need to gather all the facts before choosing surgery after a prostate cancer diagnosis.
For more information, please visit

17. Financial assistance is available
The Genomic Access Program (GAP) takes every possible step to ensure that testing is:
Affordable
Available
Accessible
If your potential out-of-pocket costs exceed $100, GAP will contact you by phone to help you understand these costs
You are eligible regardless of your insurance status
Genomic Health contracts directly with most insurers or third-party payers to secure the best coverage possible
GAP contacts your insurance company to determine whether you are covered for the Oncotype DX® test
You can prequalify for patient assistance on the spot simply by providing some basic financial information
Genomic Access Program (GAP) Video:
Genomic Health CEO Kim Popovits and thought leading physicians talk about the Oncotype DX Prostate Cancer Assay and the Genomic Access Program (GAP), which assists prostate cancer patients with the insurance reimbursement process.
Reference:
Patient Education Brochure
GAP Brochure

18. A patient’s perspective Choose with confidence
“Gain as much information as possible to make the best decision for yourself.”
-Dan W.
Oncotype DX®
Prostate Cancer
Patient Ambassador ”

19. Your Prostate Your Decision
Your Prostate Your Decision
is a national campaign to educate patients and their loved ones that every man is different and every cancer is unique, and a genomic test can clarify the aggressiveness of one’s disease prior to invasive treatment.
In partnership with three prominent national patient advocacy organizations (Men’s Health Network, PHEN, ZERO) and Joe Torre, four-time world champion baseball Hall-of-Famer and prostate cancer survivor, we are launching Your Prostate Your Decision campaign to educate patients and their loved ones that every man is different and every cancer is unique, and a genomic test can clarify the aggressiveness of one’s disease prior to invasive treatment.
This is a broad, multi-media patient education effort to provide tools to help patients have discussions with their health care team. The public service announcement featuring Joe Torre that begins to air/appear across the country this week, urges patients to discuss genomic testing with their physicians. The campaign’s website, provides tools they need to have a more productive discussion with their doctor.
This first-of-its-kind national effort aims to address concerning results of a large national survey conducted with support from MHN, PHEN and ZERO, that found low general awareness about prostate cancer aggressiveness and treatment options, underscoring the need for better understanding of active surveillance as a treatment plan.
To view the website or watch the video with Joe Toree on YouTube, go to:
Joe Torre, Prostate Cancer Survivor,
4-time World Champion and Baseball Hall-of-Famer
Watch a public service announcement
Featuring baseball Hall-of-Famer &
prostate cancer survivor Joe Torre

20. Resources for your prostate cancer journey
Reference: Online Resource Guide

21. 1 2 3 4 Next steps LEARN MORE CONSIDER YOUR OPTIONS ASK YOUR DOCTOR
about your prostate cancer
CONSIDER YOUR OPTIONS
you have time to choose with confidence
ASK YOUR DOCTOR
about the Oncotype DX® Prostate Cancer Assay
CALL
PROSTATE 2 3 4

22. Thank You