Two Tests Provide More Accurate Predictions
After a radical prostatectomy, patients normally wonder "What is the risk that my cancer will spread?" Today, physicians typically use a predictive tool called a nomogram that features data from the patient's tumor to calculate the risk of progression of their prostate cancer.
We have identified two additional blood tests that improve the accuracy of a nomogram's prediction of the outcome after a radical prostatectomy for prostate cancer. These tests measure the blood levels of "markers" TGF-b1and IL-6-sR, which appear to be associated with the process of metastasis or cancer spread.
These tests are the result of four years of research described in national peer-reviewed scientific publications (see list below).
These tests are not screening tests for cancer. Currently, they are used for staging and for prediction of progression after primary therapy.
We have also found that the marker levels, used in conjunction with this nomogram, are accurate predictors of prostate cancer progression in patients who are planning to have a radical prostatectomy. We are currently developing and validating nomograms which use these markers for our patients who have already undergone a prostatectomy, who are undergoing or contemplating radiation therapy for treatment of prostate cancer, or who have developed recurrence after one of these therapies. These markers may also be useful in helping to manage patients with other cancers, such as kidney or bladder cancer.
Because these tests are not widely available and have not been FDA approved, their cost is not currently covered by Medicare and most likely will not be covered by patient insurance. However, if your physician believes that these tests would be helpful, your physician may offer you the option of having these tests performed at your cost.
Publication References
Shariat SF, Shalev M, Menesses-Diaz A, Kim IY, Kattan MW, Wheeler TM, Slawin KM: Preoperative plasma levels of transforming growth factor b1 strongly predict progression in patients undergoing radical prostatectomy. J Clin Oncol 19:2856-64, 2001.
Shariat SF, Andrews B, Kattan MW, Kim J, Wheeler TM, Slawin KM: Plasma levels of Interleukin-6 and its soluble receptor are associated with prostate cancer progression and metastasis. Urology 58:1008-1015, 2001.
Kattan MW, Shariat SF, Andrews B, Zhu K, Canto EI, Matsumoto K, Muramoto M, Scardino PT, Ohori M, Wheeler TW, Slawin KM: The addition of interleukin-6 soluble receptor and transforming growth factor beta1 improves a preoperative nomogram for predicting biochemical progression in patients with clinically localized prostate cancer. J Clin Oncol 21(19):3573-3579, 2003.
