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Cancer: Prostate Message Board
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Old 08-22-2012, 01:29 PM   #1
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Prosta Vysion and Ploidy Test at Bostwick

Has anybody went through thest tests?

For those that have, please comment on these two tests.

Thanks,

mP

 
Old 08-22-2012, 05:54 PM   #2
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Re: Prosta Vysion and Ploidy Test at Bostwick

A friend of mine had it done and showed me the report. In his case it was not very useful. I struggled with the meaningfulness of the values. I guess if they were extreme they might have been more useful, but if they were extreme, he'd probably have other clues from better-validated tests.

- Allen

 
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Old 08-22-2012, 06:22 PM   #3
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Re: Prosta Vysion and Ploidy Test at Bostwick

Quote:
Originally Posted by Tall Allen View Post
A friend of mine had it done and showed me the report. In his case it was not very useful. I struggled with the meaningfulness of the values. I guess if they were extreme they might have been more useful, but if they were extreme, he'd probably have other clues from better-validated tests.

- Allen
Allen, I was hoping to use the report to help me make a decision on AS option. My Uro mentioned on the phone that my Bx result qualifies me as an AS candidate. I was a bit surprised as most of what I read says two cores or less, mine is 3 out of 14 cores, involves both lobes, though all G6 and max out at 20%. Another thing is I am 59, no where near 65.

 
Old 08-22-2012, 07:06 PM   #4
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Re: Prosta Vysion and Ploidy Test at Bostwick

Your Uro is well-informed. Many institutions have greatly loosened their requirements for AS in the last few years. NCCN hospitals now include it as a possible option for anyone with "low risk" disease, no matter what the life-expectancy, the % of cores etc. Some centers still hold to a requirement of "very low risk" disease: a third or fewer cores positive, less than 50% of any one core, T1c-T2a, Gleason 6, and PSA<10 -- but you would still qualify under that more stringent requirement. (It would be a preferred option with a life expectancy less than 10 years.)

With PHI (and maybe TMPRSS2:ERG fusion) available soon, PCA3, and lots of fancy imaging options, it's easier than ever to know if the cancer progresses.

- Allen

 
Old 08-23-2012, 07:39 AM   #5
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Re: Prosta Vysion and Ploidy Test at Bostwick

With PHI (and maybe TMPRSS2:ERG fusion) available soon, PCA3, and lots of fancy imaging options, it's easier than ever to know if the cancer progresses.

Interesting that you mentioned TMPRSS2, I believe City of Hope is actually conducting a study on this, I remember asking the nurse about it two months ago and she said it was not yet completed. Wonder how long will it be before the FDA approves it, will it really help? How accurate will the test be? Also surprised that Prosta Vysion has not been used by many, my insurance company requires preapproval which they will probably deny (same as the denial on color doppler US). If I remember it correctly, PHI has just been approved but does not apply to my case?

mP

 
Old 08-23-2012, 10:42 AM   #6
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Re: Prosta Vysion and Ploidy Test at Bostwick

They all are different parts to the puzzle. PHI is a mixture of three different biomarkers: PSA, free PSA and [-2] ProPSA, and has very good accuracy. You can read about it here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140702/

I asked Beckman-Coulter when it will be widely available. They said possibly by the end of the year, but were very non-committal. It takes time and money to manufacture all those monoclonal antibodies and distribute the test kits. As it catches on and urologists increasingly ask for it, I think they will step up production.

TMPRSS2:ERG fusion, as well as PCA3, are not expressed by every prostate cancer (low sensitivity),but if they are, they have very few false positives (high specificity). They are unaffected by prostatitis and BPH. T2:ERG fusion predicts Gleason score, % involvement, % positive cores, stage and significance of the cancer. It’s correlated with family history. It’s not correlated with PSA or prostate density. So you can see that combining that with PHI will give you a very complete picture of your cancer, and allow you to track any progression.

I don't think that many insurance companies will pay for tests that are not FDA approved, especially if its usefulness is doubtful. I think Prostavysion has questionable diagnostic accuracy. There are just way too many genes that may or may not come into play

Will City of Hope let you in on their clinical trial?

- Allen

 
Old 08-23-2012, 10:52 AM   #7
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Re: Prosta Vysion and Ploidy Test at Bostwick

Will City of Hope let you in on their clinical trial?

I do not know, I have not met with them yet.

Also, I had my gall bladder removal surgery in April and don't know if I am still a good candidate for surgery, just one of the options that I am considering.

Choosing treatment has to be one of the most difficult decisions in my life. My wife prefers AS, she read one of those study that shows no or little difference in life expectancy between those AS vs. Agressive Treatments.

I am scheduled to meet with Dr. Timothy Wilson at City of Hope on September 4th. This is just consultation, the nurse said that he should lay out all the options, and I will have to decide.

I am also seeing Dr. Ukimura today, first meeting post Bx. Was lucky to get the appointment as there was a cancellation.

Thanks for your responses, very helpful to me both in terms of knowledge and metal support.

mP

 
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