Background: In April 2022, Medicare introduced new item numbers for genetic testing in men with metastatic castrate resistant prostate cancer (mCRPC) to determine eligibility for olaparib under the PBS. This change resulted in increasing numbers of men being referred for genetic testing. There are unique social and ethical issues that need to be considered in these men, who, until recently have been underrepresented in genetics clinics.
Aim: This study aimed to determine the genetic counselling issues encountered by medical oncologists, when considering somatic and/or germline testing for this group of patients, and what support genetic counsellors could provide.
Methods: This pilot study, was conducted during July 2022. Clinicians were interviewed by a genetic counsellor and asked to identify the issues they encountered when arranging genetic testing for mCRPC. The doctors also reported on the level of disease education and resources they provided to these patients.
Results: The issues reported included: access to suitable tumour tissue for testing; deciding if a new biopsy if needed; the limitations of germline testing for making treatment decisions; the cost of additional genomic testing; limited time for genetics education; and identifying appropriate resources to provide to patients.
Conclusion: Genetic counsellors can play an important role in providing support to medical oncologists and in counselling men with mCRPC who are undergoing mainstream genomic testing. This study confirms the results of other studies that show the importance of providing education to oncologists and patients regarding multigene next generation sequencing in tumour samples plus/minus subsequent germline genetic testing (Shirdarreh et al, 2021).