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Posted 3/29/2014 8:32 PM (GMT 0)
I just got results back from a commercial DNA sequencing company to see if I can improve the "educated" part of the educated guess that AS is for me. I am in my second year of AS and happy with that course so far, but getting better information with better tools as time goes on is a fundamental part of the AS risk trade-off for me. I am hopeful of learning whether my broad genetic analysis results can be read and provide me with a way to better assess the probability that any cancer not found so far by the luck of the draw in 12 core biopsy might be more dangerous than the very small bit of G6 found in 2 biopsies so far. I downloaded the raw genome data set form the site I sent my sample to, and uploaded it to a service that provides some basic analysis and correlation with the current body of genomic knowledge about all kinds of health issues (promethase.com) and their genetic components.

For example, among hundreds of health related results in my report, I fall in a genotype (rs7754840(C;G)) that has "a 6.2- and 3-fold increased risk of prostate cancer and benign prostate hyperplasia (BPH), and a 5.5-fold increased risk of metastatic prostate cancer" comparatively.

This kind of info is of course enough to be dangerous, which is why the FDA has been shutting companies providing these services down - unfortunately.

So I would be interested in hearing if anyone else has done this, learned much, and has experience/knowledge/wisdom to put it to good use.

Thanks! PV
Posted 3/29/2014 8:46 PM (GMT 0)
I am wondering how accurate such predictions are, at this point in their development.
Am thinking a company does not have to provide empirical proof that such statements are in deed true. Without proof, a company might claim almost anything.
I hope such testing is valid, but not sure if they are yet.
Good luck.
Posted 3/29/2014 8:49 PM (GMT 0)
The statements are usually abstracted from literature in the field as indexed by NIH PubMED-so I think that part is reliable.
Posted 3/29/2014 9:09 PM (GMT 0)
Even a 5.5 fold increased risk of metastasis is a very low risk. I 'm unconvinced that these genetic profiles are really useful for most of us, although they may be for the rare, more extreme cases. If I were on AS, would prefer to invest in a 3T mpMRI-guided biopsy interpreted by a rockstar radiologist.
Posted 3/29/2014 9:29 PM (GMT 0)
Yeah...what TallAllen said!

Jim
Posted 3/29/2014 9:52 PM (GMT 0)
I have never heard of mpMRI-guided biopsy - is it likely my uro is not up to speed? my basic dx plan is PSA twice a year, biopsy every 18-24 mos.
Posted 3/29/2014 11:28 PM (GMT 0)
They aren't available everywhere, and I can't emphasize enough that the radiologist has to be very adept at reading them. If you are near a major tertiary care facility, they might do them there.

It involves getting a series of MRIs (T2, DWI, DCE & Spect), often with an endorectal coil in place. A radiologist then pores over them and looks for suspicious areas. In a fusion biopsy, they merge the MRIs with a real-time 3D ultrasound image. The suspicious areas as well as some random sites are then biopsied. Its ability to detect cancer is far superior to the ordinary TRUS-guided biopsy.
Posted 3/30/2014 12:57 PM (GMT 0)
Positive,
I did the AS (they called it Watchful Waiting then) for almost 2 years. I liked it because it was the only alternative that pretty much guaranteed 0 side effects. I had a 'mapping biopsy' (which may be what the other guys are talking about, but I don't know about the specifics) only after my psa rose considerably. At that point, where 60 samples were taken, it was determined that the cancer was 'significant'. My point is that it was the rise in psa which triggered the extended biopsy. In my case, the original biopsy didn't necessarily suggest a lesser disease than was present, but rather (as indicated by the rising psa) the disease progressed over the period of 2 years. All that said, I was still able to choose my treatment, and I would do the AS again. I would have done it indefinitely had the circumstances been different.
Posted 3/30/2014 3:57 PM (GMT 0)
Vibe,
Read this article on Multi parametric MRIs. the data is very good at identifying aggressive cancers and not identifying indolent cancers.

http://prostatecancerinfolink.net/2014/03/28/lets-compare-the-media-hype-to-the-actual-data-about-mr-guided-biopsy/
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