Oncotype DX Prostate Cancer Test

Thanks.

A couple more links I added to similar post on Inspire forum

http://www.genomichealth.com/Company/Perspectives.aspx#.UYqjOrXvuSp has a video

http://www.myprostatecancertreatment.org/en-US/about-Oncotype-DX/Oncotype-DX-for-Prostate-Cancer.aspx#.UYredbXvuSp

Good question.

While my Uro recommended AS for me after Dx,he never mentioned PCA3 when I first met with him, I had to ask for it. When I asked him about a recent FDA approved test (PHI), he said he was not aware?

Prolaris costs about $3,400. Oncotype Dx costs $3,820. I believe neither is covered by insurance at this time.

Genomics also does the Oncotype for breast cancer. My wife had it run two years ago and it was covered by insurance. It cost about $3k. I am not aware of these PCa tests yet being covered by insurance. Further, I don't know if they are covered by Medicare. That is usually the key. Insurance companies most often follow the lead from Medicare.

Aachen,
Unfortunately most doctors are uneducated in advanced prostate cancer testing and diagnostics. I spent ten years trying to find the cause of my high and rising psa and went to 5 urologists/oncologists at 4 major centers. Only one knew about MRIS, none recommended color doppler ultrasound which eventually discovered my cancer and none knew about Combidex. Not one used the various psa kinetics and variants like PSADT, PSA density and PSA velocity as a diagnostic tool. Not one used nomograms or the various tables available. No one offered me a PCA3. It was only after I went to a medical oncologist specializing in PC that i discovered all of these diagnostic tools. He used all of them to come up with a diagnosis and recommendation that was totally accurate. Unless a doctor specializes in PC and that's the only thing he does, don't expect a lot of knowledge on the subject or a complete DX of your condition.
JohnT

Medical oncologist uses drugs and chemo therapy to treat cancer. Rad onc uses radiation. While some rad oncs might prescrive HT they will generally not do infusions of chemo like taxotere.

Regardsing these two new tests, I think it will be a while before strong utilization will be used. Many men are just clearly very low risk and no one is going to spring for several thousand to confirm that the G6, PSA of 4, 1 of 12 cores positive for 5%, is actually what the biopsy says. At the other end my statistics indicated clearly that I am high risk. There will be those in the middle that need better confirmation that can benefit. It will be interesting to see what triggers will be used in terms of PSA and biopsy results to use one of these tests.

In the case of breast cancer, not all women have the Oncotype Dx performed. It is reserved for those that may be facing chemo, but are not at a significantly high risk that would clearly dictate chemo. My wife had a suspected micromet in a lymph node and the surgeon was also unable to get a large enough clear margin at one spot of the tumor. The med onc ran the test and the results indicated that she faced a 24% probability of recurrance within seven years without chemo. It then showed the probabilities of recurrnce having chemo in several different drug combinations and dose levels. The med onc used the test results to fine tune the chemo plan to maximize treatment effectiveness and minimize damage from the chemo.

Aachen,
To add to what JNF said, I have found that medical oncologists specializing in PC approach the disease from a biological perspective; that means they first look at the biology of the cancer, it's growth rate and its aggressiveness and make treatment recommendations based on that. Both radiologists and urologists approach the disease from a mechanical perspective and use mechanical means to address the cancer.
There are only about 100 medical oncologists specializing in prostate cancer in the US so they are a rare breed and you have to search to find them. In the appendix of "Invasion of the Prostate Snatchers" by Dr Mark Scholz, a medical oncologist specializing in PC there is a list of all the prostate oncologists in the US and their contact information.
If you read books by Dr Scholz, Dr Myers and DR Strum all medical oncologists and then read books by Drs Walsh and Scardino, urological surgeons specializing in PC or Dr Dattoli, a radiation oncologist you can see the significant differences in how each speciality approaches this disease.
It is also unique in prostate cancer that urologists, surgeons by trade, diagnose recommend and treat PC. In all other cancers a medical oncologist does the DX and treatment recommendations and uses surgeons or radiologists as part of the treatment team with the medical oncologist being the team leader and calling the shots.