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New test to distinguish fast from slow growing prostate cancers

While almost 95 per cent of prostate cancer is slow growing and found in males above 60 years, some 5 per cent is fast growing and was typically found in younger men.

Unfortunately, with a six-fold increase in forty-something males developing the disease, old lines of fast/slow growing have become blurred with the risk that doctors start treating cancers that, if left alone, would never cause a problem. Hitherto, the only way of deciding fast versus slow growth was a less than perfect Gleeson score.

Now a new test from Genomic Health has been developed aiming to save men unnecessary treatment.

Results of a study assessing the prostate test’s performance were presented at the annual meeting of the American Urological Association in San Diego.

‘It’s very hard to tell a surgeon I’d like to leave a cancer in place,’ said Dr. Jonathan Simons, president of the Prostate Cancer Foundation, a research and advocacy organization. Dr. Simons, who was not involved in the study, said the development of new genetic tests like the one from Genomic Health represented a “watershed,” akin to going from pulse rate measurements to electrocardiograms in cardiology.

Some experts said it was too early to assess how accurate the test really was and whether it would make a difference in men’s decisions. A new decision maker is increasingly involved in America – the Insurance company. They will want to know about accuracy before they cough up the money ($3,820 per test!).

Even the senior investigator of the study, Dr. Peter R. Carroll, said he was not sure.

The new test, which is called the Oncotype DX Prostate Cancer Test, is one of more than a dozen coming to market that use advanced genetic methods to help better manage prostate cancer. The most direct competitor to the Oncotype test is likely to be the Prolaris test, introduced last year by Myriad Genetics.

But Genomic Health’s test has attracted attention because of the company’s track record. It already sells a similar test for breast cancer, Oncotype DX Breast Cancer, which is widely used in America (if not in the UK) to help women decide if they need chemo after surgery. 

Genomic Health said that 26 percent of the prostate samples were classified as very low risk by its test, compared to only 5 to 10 percent for the existing methods. In some cases, however, the new test showed the cancer to be more aggressive than the existing methods.

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