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Prostox - learn about whether radiation will cause problems
Prostate Cancer | Last Active: 2 hours ago | Replies (23)Comment receiving replies
@jim18
If needed my husband will have salvage, that is not even a question ; ).
It is about planning RT - how many sessions and how many Gys total.
I know that with IMRT one can have more sessions with lower radiation or less sessions with more radiation administered at each visit and both protocols would yield absolutely same end results, BUT more sessions with less Gys would produce less AS. So- IMHO having Prostox would help with planning.
My husband had genetic testing - he has no inherited mutations of any kind, so thanks for sharing this information < 3. I did not know that it can predict sensitivity too. Very comforting to know . THANKS
PS: We were told that only doctor can order test - we can not order it ourselves or we would have done it long time ago .
Replies to "@jim18 If needed my husband will have salvage, that is not even a question ; )...."
@surftohealth88 The problem you are running into is that the company that markets Prostox wants to get it accepted by insurance and ROs so they are limiting it to where it has decision value and where they have done trials. In an Ancan presentation a few months ago they said they had not done any trials for salvage radiation. Said almost all salvage radiation was IMRT so no decision point. In the release of the standard test in Feb. 2026 they mentioned it covers CFRT for 37-45 fractions and MHFRT for 20-28 fractions. I assume the fractions quoted correspond to trials they have participated in and why 29-36 are missing. Medicine is a business and not enough money in pursuing salvage radiation testing at this time.
With no germline DNA repair variants your husband is less likely to have a high Prostox. Since Prostox requires a confirmed prostate cancer diagnosis (higher % than population with these) that will reduce his probability of a high Prostox below the 11% that score high. Prostox looks at 32 factors covering SNPs involved in DNA damage repair. inflammation, and cell stress response. So more global than just DNA repair. Like all other genetic tests this is a black box. Only general information on factors included and none on weighting. Also 8% who score low on Prostox will develop grade 2+ toxicity.
A retrospective study (80K+) of late grade 2+ GU toxicity found 90%+ were obstruction/stricture of the urethra. Patients with previous issues/treatments such as Turp were 3x more likely to have late toxicity than without any issues. Radiation still raised probability for both groups. Other common GI toxicity was 5%+ cystitis, 2% incontinence. Prostox does not cover GI toxicity.
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@surftohealth88 What am advocate you are for your husband. I am a retired lawyer and nurse and you leave in the dust. Kudos to you.