A collaborative study from investigators at several major cancer research centers has suggested that “gene expression signatures implicating specific components of the immune response” may provide better prognostic information for patients with prostate cancer than currently available data such as stage and grade.
The paper by Hsu et al. refers to data on several cancers — including adenocarcinoma of the prostate. The authors focused their research on the expression of genes believed to be important in the development and expression of host immune responses, e.g., T(H1)-mediated adaptive immunity, inflammation, and immune suppression.
Among the adenocarcinomas – which include prostate cancer — the T(H1)-mediated adaptive immunity genes were consistently associated with better prognosis, while genes associated with inflammation and immune suppression were sometimes associated with outcome but with variable degree. In the case of prostate cancer (based on data from 79 patient specimens), increased expression of the T(H1)-mediated adaptive immunity genes was significantly associated with good prognosis in all patients (p = 0.03, hazard ratio = 0.36).
As usual, we should note that this is early-stage research, and that an “association” is not necessarily the same as a cause and an effect, but the idea that the strength of an individual’s immune system may be important in his (or her) ability to fight off cancer — just as it fights off other forms of disease — is hardly a new one, and it is certainly reasonable to suppose that “the gene expression signatures implicating specific components of the immune response hold prognostic import across solid tumors,” as the authors conclude.
Filed under: Diagnosis, Risk Tagged: | gene expression, immune reponse, prognosis
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The accuracy of any prognosis is based upon the comprehensive measurement of the individual patient. Statistical averages from population studies are not suitable for individual patients and when applied to them their accuracy is about 50%. Learned and experienced physicians have an accuracy of about 20% and less if the physician knows the patient as the subjective knowledge decreases the accuracy further. In the last month of life anyone who is in recurring contact with the patient can predict their death with an accuracy exceeding 75%.
Prognosis is not simply a matter of the current illness, it is the cumulative make-up of the patient prior to birth beginning with their genotype. Their environment, medical history of conditions, injuries and degree of recovery, exercise, nutrition and more; all must be weighed. It is not a matter of measuring a single variable such as glucose in diabetes or pulmonary function in emphysema; the prognosis is based upon a myriad of factors. Disease progression that would end the life of one patient may not threaten another.
One method has been shown to be an accurate measure of prognosis in all patients in any condition; phase angle as measured by bioelectrical impedance analysis. There are more than 200 peer-reviewed professional publications in all major disease states supporting this. The reason phase angle works is that it measures the vitality of the patient’s cell membranes and the absolute value when compared (scored) to “normal” values and tracked over time in response to disease progression and the effects of treatment illustrate the patient’s response to their condition. Consider that the cells in our bodies carry our complete story and phase angle communicates it.
In patients with “terminal” disease conditions their phase angle value reveals their chance for survival at diagnosis and can be used to support better end-of-life decisions. The average phase angle value is from 5 to 9 degrees; although “normal” is age and gender based. The higher the phase angle value the healthier the patient. The rate of diminution and absolute value illustrate disease severity and treatment response. Phase angle goes down when we get sick, then returns to pre-illness values when we recover. If you do not recover completely the value doesn’t return completely and this indicates a “frailty” index. Phase angle values below 5 degrees indicate severe illness, values between 2 and 4 degrees require aggressive treatment if the condition is recoverable and values of two or less are not recoverable.
The test is simply done, requiring little patient compliance and the results immediate. There are no contraindications so the test can be repeated as needed to track disease progression or evaluate treatment effectiveness. The cost per test is less than $5.00.
The test works because it illustrates the cell membranes. Information from the cell membranes occurs before changes are seen by lab studies, imaging techniques and physical examination because they come from an earlier occurring level of the hierarchy of how biological entities are organized. By starting treatment earlier it can be more effective. By seeing if treatment works sooner it can be tailored for better effect. When treatment fails or disease overcomes us end-of-life can be better controlled.
To learn more you’ll have to read and ask questions; we look forward to talking with you.
Good Luck,
Cheers!
Michaeal G. Singer
Why do I get the impression that Mr. Singer is trying to sell me something? Oh … because he is. It’s something called PrognostiCheck! Apparently Mr. Singer (who is a qualified physician assistant) is an executive of the company.