Anyone have experience with the new DecisionDx test?

Posted By
1/2/2018 7:54pm
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Replies: 9

Hello Everyone,

My Doctor suggested this DecisionDx test to see how likely my melanoma is to return.  Has anybody had this test done?  What is the cost? Does Insurance cover it?  

Thanks for any comments.


I had when derm recommended, at that time there was no cost to patient although they are trying to collect from insurance, but will not bill me. I would check carefully because I believe it was about 8 thousand dollars. Result came in 2 or 3 weeks as I remember. 

I came back in highest risk category, 2b which was not surprising. So far no recurrence though. There is another thread if you use search box here. 

Best wishes, 


Joyce, That's great you have had no recurrence so far! How long since your DX diagnosis?

My DX score was a 2b also which I found out 2 days ago, even though I've been a Stage 2a. It was a surprise to me, as I had the WLE with results saying clear margins Seems as though the doctors I've talked to have a lot of faith in this DX test. I was hoping they'd have a ways to go yet in their accuracy, but it sounds right on for the most part.

Don't like my DX diagnosis after feeling good about everything for weeks re: my stage 2a and clear margins. Well now I have to keep positive more than ever since I found out much more information from this test.


Hi Terry, It is not new, they have been trying to get this to market for the last decade!!! Here is a link to the topic of Biomarkers in Cancer Immunotherapy, with Melanoma references, because Immunotherapy has broken out in other cancers from Melanoma research.


Just called Castle and was told if you have insurance they will bill your insurance.  If insurance does not pay they will write it off.  They said they do not bill the patient. 

There have been several discussions about "decision dx" on this forum...use the search bubble if you are interested.  I think the marketing that Ed is referring to is more about this company trying to get a toe hold in this patient population and greater prescription by doctors.  Currently they are willing to provide it for "free", when they must, to get that grip on this "niche" market...if you will.  That is not to say there is no value in what they are selling.  Here is a post on Decision Dx that I put together over a year ago:

I really think that we are on the cusp of having some excellent tests that, through a simple blood draw, we will be able to ascertain tumor burden, response to therapy, predictors of the most effective therapy for the particular patient, etc.  However, we are not quite there yet...and when we are, I am not at all certain that Decision Dx will be THAT test.  Still...if you take the info you gain with a grain of salt and it is really "free"....what the heck?  Go for it.

Here is a post, with many links within, that addresses the many efforts toward biomarkers that I think hold much more promise:  

I wish you my best.  Celeste

Thank you all for the time to reply I really appreciate it.  Good information.

My only thought is know what you will do with the informatikn if it comes back high risk.  I had a dr suggest it- it CR back high risk, and his words to me when I asked about next steps where “ I don’t know, you’re my first.”   Not saying that will be your experience, but just something to think about.  Mine did come back highrisk....and I will (prayerfully) be 4 years NED in April. 

My Doctor did say they still don't know what to do with the results yet if positive.  He said he may order a CT scan.  Still waiting on results.  BTW My Doctor is Dr. Jason Luke at University of Chicago.

Great to hear, your in good hands from what others have said and his reputation in the field is off the charts!!!