Oncotype vs. Adjuvant!Online

Dani18

I have a question, I was orginally told to have chemo based on Adjuvant!Online but offered Oncotype.  Oncotype came back low so now it's no chemo.  When I questioned my MO about the different results she advised that if I was having doubts about not doing chemo I shouldn't have had the test as it would just confuse me.  I've done so much research and know that in my case the negatives of chemo probably don't outweigh any potential benefit but I'm just confused.  If Oncotype is a better test why isn't it done automatically in the appropriate cases.  It's just hard to get my head around not doing chemo based on one test over another, especially when it's a test that is offered in so few provinces in Canada.

I would love any input on the subject.

voraciousreader

Dani, Adjuvant! and another gauge, PREDICT do not look at the actual biology of each individual tumor. Oncotype DX does and then makes a prediction. Before the Oncotype DX and other genomic tests were developed, physicians could only make general predictions about prognosis and treatment decisions could only be based on that info. The Oncotype DX test gives specific info. Interestingly, the test most often will confirm what physicians already think about the tumor, while on a few occasions it might point to a more or less aggressive disease than previously thought. Some patients, like your physician said, might be leery of the test. Keep in mind, the test has only been offered for a few years AND there are more trials being conducted to help patients who get dreaded intermediate scores, because, as of now, no one knows the risks and benefits of chemo for them. Another trial is also trying to pinpoint whether chemo is appropriate for early stage ER positive sisters with one to three positive nodes.



Here in the States many insurance companies cover the test...but patients who do not fit certain benchmarks might be refused. Still, like in Canada, there are some insurance companies who do not approve it at all. Recently though, I am seeing fewer insurance companies deny the test.





The bottom line is no test is perfect and once you make an informed treatment decision, you will never know with certainty that you made the right decision and will never recur. Despite the unpredictability of cancer, you should feel better knowing you got a low score. Good luck with active treatment!