Prolaris, A Genetic Test To Predict Prostate Cancer Aggressivness Is Now Covered By Medicare

There have been a number of new genetic tests that have become available, which are designed to help a man diagnosed with prostate cancer make better initial treatment decisions.  One of these new tests, the Prolaris Test, developed by Myriad Genetics, is designed to help predict the aggressiveness of the prostate cancer. 

Not all prostate cancers should be treated.  Many prostate cancers are not aggressive and are not going to progress or progress at a very slow rate.  In these cases, the actual treatment side effects put a man at a greater risk of harm and could also decrease a man’s quality of life that would be worse than the cancer itself. 

Medicare has been covering the Polaris test for men with low and very low-risk cancer.   A recent decision coming from Centers for Medicare and Medicaid Services (CMS) has expanded the coverage to now include men with intermediate risk prostate cancer.  This decision comes after Palmetto GBA, a Medicare Administrative Contractor (MAC) that assesses molecular diagnostic technologies, issued a positive final Local Coverage Determination (LCD) to expand Medicare coverage of the test.

In a recent press release Mark C. Capone, President and CEO of Myriad Genetics said, “We are excited that the MolDX program has expanded Prolaris coverage to the thousands of Medicare beneficiaries with favorable intermediate risk prostate cancer.  The coverage decision is another important step to make sure the Prolaris test is broadly accessible to the patients who need it.”

Polaris works by measuring the molecular biology of the prostate cancer.  It does this by measuring the expression levels of 46 genes involved in cancer cell proliferation and aggressiveness as captured from a diagnostic biopsy. Prolaris has been validated to predict 10-year prostate cancer-specific mortality in untreated men.

Using the test allows us to identify men who have a less aggressive disease and who are good candidates for active surveillance. On the other side of the equation, the test also identifies men who have more aggressive prostate cancer requiring treatment.

Joel T. Nowak, MA, MSW wrote this Post.  Joel is the CEO/Executive Director of Cancer ABCs.  He is a Cancer Thriver diagnosed with 5 primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma and a rare cancer, Appendiceal Cancer.