Predicting Recurrence of Prostate Cancer

Physicians often use a tool called a nomogram that uses features of a patient's tumor to predict the risk of progression of their prostate cancer. Until recently these features were limited to Gleason Score, prostate specific antigen (PSA) level, and clinical stage. These features provide a reasonable amount of information to suggest a prognosis, but two additional blood tests improve the accuracy of the nomograms. These tests measure the blood levels of "markers" TGFβ₁ and IL-6 sR, which appear to be associated with the process of metastasis or cancer spread. Their elevation suggests an increased risk for developing metastatic cancer.

Having established the usefulness of these markers with four years of extensive research, we are now ready to offer tests for these markers to patients. (For published study results click here.)

For Prediction Only

These tests are not screening tests for cancer. Currently, they are used for staging and for prediction of progression after primary therapy.

We have developed a nomogram* for prostate cancer that includes features such as blood levels of TGFβ₁ and IL-6 sR, as well as PSA, clinical stage, and primary and secondary biopsy Gleason Grade. We have found the nomogram to be a very accurate predictor of prostate cancer progression in patients who are going to have a radical prostatectomy. This nomogram currently is undergoing validation at other institutions that also specialize in the treatment of prostate cancer. In addition, we are developing and validating nomograms incorporating 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. Furthermore, our data also suggest that these tests may be useful in helping to manage patients with other cancers, such as kidney or bladder cancer.

*NOMOGRAM a predictive calculator for prostate cancer

Patient Involvement/Cost

The cost of both the TGFβ₁ and IL-6 sR tests are $300.00 per set. Individually, each test is $150.00.

Because these tests are not widely available and have not been FDA approved, their cost is not 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.

For the patient, the test involves only the drawing of blood. However, the process for evaluation requires precise handling. Your physician will need to make certain that the laboratory follows very specific instructions. These are attached or may be requested from: