Prostate cancer diagnosis and treatment are moving towards more individualized approaches. Understanding each patient’s cancer characteristics is important for effective management. This shift aims to tailor treatment strategies based on tumor aggressiveness, improving outcomes while minimizing unnecessary treatments.
What is the Decipher Prostate Test?
The Decipher Prostate Test is a genomic test that analyzes the activity of specific genes within a patient’s prostate tumor sample. It provides a genomic risk assessment, predicting the cancer’s aggressiveness and the likelihood of it spreading or returning after initial treatment.
The test offers insights into the tumor’s potential behavior by examining gene expression patterns. It helps in understanding whether the cancer is likely to remain confined or become more aggressive over time. The information derived from the tumor biopsy or surgically removed tissue sample contributes to a comprehensive understanding of the individual patient’s cancer risk profile.
When is the Decipher Test Used?
The Decipher Prostate Test is typically recommended in specific clinical situations to refine risk assessment. One common scenario is after an initial prostate cancer diagnosis, particularly for men with intermediate-risk localized prostate cancer. The test helps determine if active surveillance (close monitoring without immediate treatment) is a suitable option, or if more aggressive intervention is necessary.
The test is also used for men who have undergone a prostatectomy (surgical removal of the prostate). After surgery, the Decipher test assesses the risk of cancer recurrence. This assessment guides decisions about whether post-operative radiation therapy is warranted to reduce the chance of the cancer returning.
How the Decipher Test is Performed
Performing the Decipher test begins with obtaining a tissue sample from the patient. This sample is typically collected during a prostate biopsy, which is a common procedure to diagnose prostate cancer. Alternatively, tissue from a surgically removed prostate (prostatectomy specimen) can also be used. A small amount of this tumor tissue is sufficient for analysis.
The sample is sent to a specialized laboratory for processing. There, genetic material, specifically RNA, is extracted from the tumor cells. The expression levels of 22 specific genes known to be associated with prostate cancer aggressiveness are then precisely measured.
The measured genetic data is then processed through a proprietary algorithm. This algorithm analyzes the expression patterns of the 22 genes to generate a “Decipher Score,” which quantifies the genomic risk of the prostate cancer and its potential for progression.
Understanding Decipher Results and Treatment Paths
The Decipher Score is a continuous number, typically ranging from 0 to 1, with higher scores indicating a greater genomic risk of metastasis or recurrence. This score is then often categorized into risk groups, such as low, intermediate, or high risk, to help guide clinical interpretation. Understanding where an individual’s score falls within this range is important for treatment planning.
A low Decipher score may support a less aggressive approach, such as active surveillance, where the cancer is closely monitored without immediate treatment. For patients with an intermediate score, the test can help differentiate between those who might continue with active surveillance and those who would benefit more from definitive treatments like radiation therapy or surgery. The score helps clarify the biological risk.
Conversely, a high Decipher score often suggests a need for more aggressive or multimodal therapy, potentially combining surgery with radiation, or more intensive follow-up. This indicates a higher likelihood of the cancer spreading or recurring. The Decipher score is used by healthcare providers in conjunction with traditional clinical factors, such as PSA levels and Gleason score, and patient preferences to develop a personalized treatment plan.