Not enough cells to perform a Prolaris test?!?!

I had the standard 12 core biopsy back in 11/17. Sent cells for a Prolaris test and was recently told there was not enough cells for the lab to perform the test. Btw...samples were sent twice! Not sure what is going on? Is this unusual?

I've heard it a number of times. Remember that Prolaris (and Oncotype Dx and Decipher) are designed to be tie breakers. They are for men whose biopsy results are equivocal for AS (i.e., high volume of low grade cancer, high PSA density, or presence of some GS 3+4). They aren't designed for men like you who are unequivocally good candidates for AS. They are very expensive, and usually will not assist in decision making.

Is a positive feeling worth $3,000-4,000? You are clearly an excellent candidate for AS with or without it. MSKCC is usually right.

Hi dbell,

I had the same result..."insufficient carcinoma cells" for my Oncotype Dx test. I actually thought the Pathologist was sending it out for a Polaris test because that is what my Uro office had said.

I think it happens more than we know. The Pathologist that prepare the slides said it can be difficult to get enough cells when the percent and density of the tumor sampled is low. The amount of tissue captured by the "whispy" (his technical term) thin needle biopsy is not much.

I am seeking treatment. I just thought knowing more on how aggressive the cells were multiplying might influence my treatment choice to hit as hard and fast as needed. If very aggressive (beyond what the Gleason score might indicate) I may have then looked more at some combination therapy (IRMT plus hormone therapy or boost) that possibly included a broader treatment area if I had some additional reason to believe it may not be confined to the prostate. I know my potential SE's would have been more but then perhaps justifiable so hoping for a cure. Only way to know this for sure is to chose surgery as the primary treatment which comes with it's own risks and rewards.

Good luck with your decision. Being here, I know you have already made a good one.

No, see my signature. These type of tests, including bone scans, are usually not very sensitive for determining cancer spread in very early stages after metastasis. So you really need to be a much higher risk candidate (GS8, PSA >20) to worry too much. i am not up on all the protocols for those continuing on AS so I can't really comment. Tall Alan is giving you some really good advice.

Go slow....research until you are comfortable (we never actually get there as we all worry) and remember you only get one 1st shot at what you do as far as primary treatment if/when it becomes necessary.

You will be fine!