Prostate Cancer: A New Test To Determine if Watchful Waiting is Appropriate

Prostate cancer affects 1 in 6 American men and causes over 25,000 deaths per year, making prostate cancer the second most common cause of death due to cancer in men (first is lung cancer).

Men who have a biopsy that is positive for prostate cancer are confronted with a decision regarding treatment. If the man has a life expectancy of greater than 10 years, he would be a candidate for surgical removal of the prostate gland, radiation therapy, or even a program of watchful waiting or referred to as active surveillance. So what is a man to do with a diagnosis of prostate cancer? Now there is a test, Prolaris, that will help men decide which cancers are aggressive and may require more aggressive treatment, i.e., surgery or radiation, and which cancers are indolent and the men may be candidates for watchful waiting.

Until now the only consideration for men with prostate cancer was the grade of the cancer and the stage of the cancer. However, there are men with low PSA levels and a low grade or Gleason score, who have an aggressive tumor as determined by the Prolaris test and perhaps should consider additional treatment.

How is the Prolaris test performed?

The doctor can submit your original prostate biopsy for analysis and this will look at several genetic markers to determine the Prolaris score. No additional blood test or biopsy is required. The Prolaris test provides an accurate assessment of the aggressiveness of your tumor.

The Prolaris score provides information that helps you and your doctor make the best treatment decision. For example a low risk Ca and low Prolaris score, may persuade you to consider watchful waiting and have close follow up with a digital rectal exam and a PSA test every 3-4 months. On the other hand, a high Prolaris score is suggestive of an aggressive tumor and more aggressive treatment may be selected.

Bottom Line: Until now no lab test or imaging study can determine the aggressiveness of your prostate cancer. Now you and your doctor can make a more informed decision about the potential of your cancer to remain slow growing and you would be a candidate for watchful waiting or the prostate cancer is more aggressive and more aggressive therapy is in order.

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