DecisionDx-Melanoma (Castle test): When is it necessary?

Posted by birdman518 @birdman518, Nov 2, 2021

After having melanoma removed from my scalp in June, I had my first checkup today with my original dermatologist that found it. He mentioned that I might want to have a Castle test done. From reading about it on the company's website, it almost sounds as if it is for people who have *not* had a SNB and are trying to decide. I *did* have them and all came out clear.
It sounds like the Castle test does not really give much actionable information for someone like me. I am going to reach out to my surgeon (at Moffitt Cancer Center in Tampa) to see what they say about it. So far they have said I am clear and only need to have quarterly checkups with my dermatologist like anyone else.
I would appreciate any comments or experiences….

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@birdman518 I also have had melanoma surgery, but was not given any information on this test, nor the company.

It seems you need to look at your case specifically. Your age, what stage was the melanoma they removed, how deep was it, any post surgery treatment suggested by the surgeons. In regards to the Castle test, is this something your insurance will cover, or are you on the hook for it completely? If you need to pay for it, what is the cost and how accurate is it? Does your doctor have any other patients who did the test and were satisfied with the results?

Your plan to reach out to the surgeon sounds like a sound one, to me. Let me know what they say!


Ginger, thanks for your response. Since my oncologist/surgeon already did a SLN excision (all clear) I suspect they may say it is not necessary.


@birdman518 – I wonder if your original dermatologist might think the test could provide some additional information or possible treatment options for you? Here's some information I found that may shed some light on the topic and help or confirm your reasoning.

Integrating 31-Gene Expression Profiling With Clinicopathologic Features to Optimize Cutaneous Melanoma Sentinel Lymph Node Metastasis Prediction:
Molecular Biomarkers for Melanoma Screening, Diagnosis and Prognosis: Current State and Future Prospects
Uveal Melanoma Patient Attitudes Towards Prognostic Testing Using Gene Expression Profiling


I did run this by my oncologist and he stated that I do not need this. Remember that I had my melanoma excised AND had my SLN biopsied… all is now considered clear.

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