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Prostate Cancer

Prolaris Test - 46-Gene Prostate Cancer Biomarker

Prolaris is a genomic test that measures tumor cell‑cycle activity to predict how aggressive a prostate cancer is and the risk it will progress or recur. Its results can help guide treatment decisions—potentially avoiding unnecessary surgery or radiation for low‑risk disease and identifying cancers that need timely, aggressive therapy to reduce the chance of advanced prostate cancer.

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Key Insights

  • Understand how this test reveals your tumor’s current biological behavior — the pace of cancer cell growth that signals how aggressive the disease may be.
  • Identify a genomic risk signal (the cell cycle progression score from a 46‑gene panel) that helps explain why two cancers with the same PSA and Gleason score can behave very differently.
  • Learn how factors like tumor grade, PSA, and stage combine with your genomic result to shape an individualized risk estimate for progression or metastasis.
  • Use insights to guide choices with your clinician — from confidence in active surveillance to intensifying treatment when biology looks more aggressive.
  • Track how your risk landscape changes over time by pairing genomic results with trends in PSA, imaging, and pathology.
  • When appropriate, integrate this test with related panels (e.g., inflammation or metabolic markers) and standard prognostic tools for a fuller, more precise view of risk.

What Is a Prolaris Test?

The prolaris test is a genomic assay that analyzes activity in a 46‑gene cell cycle panel from your prostate tumor tissue. By measuring expression of genes that drive cell division — alongside housekeeping genes for calibration — it generates a cell cycle progression (CCP) score that reflects how quickly cancer cells are likely growing. The sample is typically formalin‑fixed, paraffin‑embedded (FFPE) tissue from a prostate biopsy or surgery. Results are produced using quantitative reverse‑transcription PCR (RT‑qPCR), a highly sensitive method for measuring gene expression in preserved tissue, and are compared against reference cohorts to translate the biology into a standardized risk metric.

Why it matters: cancer aggressiveness isn’t just what we see under the microscope; it’s what the tumor is doing at a molecular level. The prolaris test captures that tumor biology and links it to outcomes, informing decisions about active surveillance versus definitive treatment, and, after surgery, whether to add radiation or systemic therapy. In plain terms, it complements PSA, Gleason grade, and stage by quantifying the engine that drives tumor growth. This gives you and your care team objective data about near‑term behavior and longer‑term risk — a clearer view of where you stand today and how to plan forward.

Why Is It Important to Test Your Cell Cycle Progression Signature?

Cell cycle genes are the control panel for cell division. When they’re turned up in prostate cancer, tumors tend to grow and spread faster. Testing your cell cycle progression signature can uncover hidden aggressiveness that routine measures may miss, or, conversely, confirm that a tumor’s growth program is low and compatible with watchful monitoring. This is especially relevant at diagnosis (to choose between active surveillance and treatment), in favorable‑intermediate risk disease (to refine how “favorable” it truly is), and after prostatectomy (to judge the benefit of adding radiation when pathology findings are borderline). The result anchors risk to tumor biology — not just to how the biopsy looked on a few thin slices.

Zooming out, this kind of genomic testing supports prevention and outcomes by aligning treatment intensity with actual risk. It helps detect early warning signs of aggressive behavior, measure progress across time, and see how interventions are affecting core pathways of tumor growth. The goal isn’t to “pass” a test; it’s to reveal the tumor’s operating system and use that information to make smarter, more confident decisions that protect function and longevity.

What Insights Will I Get From a Prolaris Test?

Your report displays a CCP‑based score and, in many cases, an integrated risk estimate that combines the genomic result with clinical factors such as PSA, Gleason grade group, stage, and age. Scores are interpreted relative to validated reference cohorts, so you’ll see where you fall compared with typical outcomes. “Normal” isn’t the target here — instead, lower scores suggest more indolent biology, while higher scores signal a greater likelihood of progression or metastasis. Context matters: a modestly elevated score may carry different implications in a very low‑risk biopsy versus a higher‑grade tumor.

Lower or “favorable” genomic values generally indicate slower cell division and a lower risk trajectory, often aligning with strong candidates for active surveillance when other features fit. Higher values suggest faster cycling and a greater chance of adverse pathology or spread over time, which can motivate a shift toward definitive local therapy or combined approaches in appropriate cases. These results don’t diagnose cancer — they refine risk within a confirmed diagnosis and guide depth of evaluation with your care team.

The real power shows up in patterns. When tracked alongside PSA trends, imaging, and pathology over time, the genomic signal helps your team see where risk is heading, not just where it has been. That supports preventive care, earlier detection of meaningful change, and a tailored plan that respects both cure potential and quality of life.

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Frequently Asked Questions About

What do Prolaris tests measure?

Prolaris measures the expression of cancer cell cycle–related genes in a tumor sample: it quantifies mRNA levels of a panel of cell‑cycle progression (CCP) genes normalized to housekeeping genes to generate a CCP score.

The CCP score reflects tumor proliferation and aggressiveness; higher scores indicate a greater likelihood of disease progression, recurrence, metastasis and cancer‑specific mortality. The test is reported as a molecular risk score and is used together with clinical and pathological factors to help guide prognosis and treatment decisions.

How is your Prolaris sample collected?

Prolaris is performed on prostate tumor tissue obtained during a routine diagnostic prostate biopsy or from prostate surgery (for example, a prostatectomy or TURP). The test uses formalin‑fixed, paraffin‑embedded (FFPE) tissue blocks or unstained slides that contain tumor cells—it is not a blood or urine test.

Your urologist or pathologist identifies the tumor-containing tissue from the existing diagnostic specimen and sends the selected blocks or slides to the testing laboratory; no additional procedure is usually required beyond the biopsy or surgery. The laboratory analyzes the tissue and returns a Prolaris score to help inform personalized care and treatment discussions.

What can my Prolaris test results tell me about my cancer risk?

Your Prolaris result gives a genomic cell‑cycle progression (CCP) score that reflects how rapidly tumor cells are dividing; a higher Prolaris score indicates a greater likelihood that a prostate cancer will behave aggressively, progress, or recur over time. Clinicians use the score alongside PSA, Gleason grade, and clinical stage to stratify risk and help guide choices such as active surveillance versus definitive treatment.

Limitations: Prolaris does not diagnose cancer, does not predict outcomes with absolute certainty, and should be interpreted by your clinician in the context of other clinical information. These results are for people to understand their personal Prolaris levels and nothing else.

How accurate or reliable are Prolaris tests?

Prolaris measures expression of cell‑cycle–related genes to produce a score that estimates tumor aggressiveness and the risk of progression or prostate‑cancer mortality; multiple clinical studies have shown it provides independent prognostic information beyond traditional clinical and pathological factors, so it is considered a useful and validated tool for risk stratification.

However, Prolaris is not a diagnostic test and is not 100% accurate — results carry uncertainty, can be affected by sample quality and tumor heterogeneity, and should be interpreted alongside PSA, biopsy/Gleason data and clinical judgment; it helps inform but should not alone dictate treatment decisions.

How often should I test my Prolaris levels?

Prolaris testing frequency is individualized — most patients have a baseline test at diagnosis to help guide treatment decisions, and routine repeated testing is not required for everyone.

Repeat Prolaris is usually considered only if your clinical situation changes (for example rising PSA, new or worsening biopsy findings, or when re-evaluating management such as moving from active surveillance to treatment); your urologist or oncologist can recommend the appropriate timing for any repeat testing.

Are Prolaris test results diagnostic?

No — Prolaris test results highlight patterns of biological imbalance or resilience and provide prognostic information, but they are not standalone medical diagnoses for cancer.

Results must be interpreted alongside symptoms, medical history, clinical examination and other laboratory, imaging or biomarker data by a qualified clinician who integrates all information to make diagnostic and treatment decisions.

How can I improve my Prolaris levels after testing?

The Prolaris (CCP) score reflects the proliferation activity of the tumor tissue sampled, so the most reliable ways to change that score are by treating or removing the tumor (for example with surgery, radiation or systemic therapies such as androgen‑deprivation or other cancer-directed drugs) — decisions about those options should be made with your urologist/oncologist based on stage, overall health and treatment goals. Active surveillance is an alternative strategy for low‑risk disease but is intended to monitor rather than “improve” a molecular score; repeat Prolaris testing requires a new biopsy and is done only when clinically indicated.

There is limited direct evidence that lifestyle changes alone will lower a Prolaris score, but improving general health — regular exercise, maintaining a healthy weight, good blood‑pressure and blood‑sugar control, quitting smoking, and a balanced diet — can improve overall outcomes and tolerance of treatments. Avoid claims of supplements that promise to change molecular test results unless supported by rigorous trials. Discuss options for treatment, follow‑up testing, and possible clinical trials with your care team to get a personalized plan; this information is not a substitute for medical advice from your providers.

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