Did Decipher GRID report help guide your treatment decisions?

Posted by handera @handera, Jan 11 5:18pm

I'm 67 years old with a prebiopsy PSA of 7.8, three mpMRI PIRADS lesions of 3, 4, & 5 and my MRI fusion biopsy found 5 cores of very low volume 3+3 and 2 cores of low volume Gleason 3 + 4, out of 15 cores. I was considering Active Surveillance (AS) and requested a genomic test. My urologist suggested Decipher. My doc gave me the standard 3 page Decipher "Patient Report", which was helpful, but someone in this support group suggested obtaining the more detailed Decipher GRID report.

I called a Decipher representative and received my GRID report, in 15 minutes, by email - and am I glad I did! My diagnosis was "borderline" for AS, so the additional GRID information helped to confirm this treatment decision. Page 2 of the GRID report includes an easily understandable "Clinical-Genomic Risk Model" (see attachment). Essentially, the combined model helped to confirm that AS is a viable choice for my diagnosis and my urologist agrees.

Has anyone obtained both the Decipher "Patient Report" and Decipher GRID report? What was your experience with the usefulness of this information and did it influence your treatment decision?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

imbimbo | @imbimbo | Apr 27 7:51am

In reply to @handera "The 23 min video explaining the Decipher GRID report has a new link, found here: https://youtu.be/28AljSdy434?si=aB5E45OAa9kJI8Vb" + (show)

The video was removed and my phone reported malware

handera | @handera | Apr 27 11:10am

In reply to @imbimbo "The video was removed and my phone reported malware" + (show)

Sounds like you have a problem with your phone. Double checked and the video works fine…there’s definitely no malware involved, the video was issued by Decipher by Veracyte, the company behind this genomic test. Maybe you should have your phone checked by your provider…

The video is narrated by Dr. Ashley Ross, an Associate Professor of Urology and Clinical Director for the Polsky Urological Oncology Center at Northwestern Feinberg School of Medicine. Dr. Ross received his MD and PhD in medicine from John Hopkins.

His credentials to speak about this subject, as an accomplished clinician and surgeon-scientist specializing in prostate cancer, genomics, immunology, targeted therapies, and clinical trials speak for themselves…you can look them up…once you get your phone fixed.

rice | @rice | May 5 12:28pm

My first biopsy they found 3+4 in less then 2% of one core that was on 2021 the sample was to small to get a decipher test. I changed doctors and he’d did a transperineal biopsy no change in the one core but they found another core 3+3 in less then 25 % of one core. My doctor does not think much ov decipher test. Should I insist I get one it would be reassuring that I am doing the right thing by watchful waiting.

toolbelt | @toolbelt | May 5 1:40pm

In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)

If you would provide your age, your PSA history, and any MRI data, people can make more informed comments.
Generally Decipher is not indicated for 3+3
Thanks.

gently | @gently | May 5 4:37pm

In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)

Rice, decipher will give you useful information. With no change if the 3+4 if the sample is large enough this time, I'd ask for it. Not sure if your provider is dismissive of Decipher of decipher for you at this point.
You might want to look at focal therapy. It good to hear of someone catching prostate cancer early enough not to treat the entire prostate. Best wishes.

rice | @rice | May 5 4:47pm

In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)

ok I am 72, My PSA has been between 4 and 8. My PSA has always been all over the place. I have had 2 MRIs, they were used for the targeted biopsy. I have had 2 Pet scans nothing is outside of the prostate. Because I had 3+4 in less then 2% 0f one core and 3+3 in 25% of another core so I am assuming that I am a overall 7 . My Doc says I am stable. My radiologist told me that if my latest biopsy did not change he could do radiation in 5 treatments and no HT. But because I have BPH he would want me to get a HELOP. That Is why I am wondering about doing the decipher test so I can make up my mind to continue active surveillance or go with Radation option. thanks

jc76 | @jc76 | May 5 4:49pm

In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)

@rice My MRI/Fusion biopsies showed 3+4=7. This indicated standard treatment of radiation and hormone as is classified at least at Mayo Jacksonville as intermediate.

Mayo R/O suggested Decipher test and it was done. It dose not require another biopsy but they use the already taken tissue. My Decipher test came back LOW RISK which removed the need for hormone treatments.

So if you asked if Dechiper test is worth in or do I think you should have it, YES. Both Mayo and UFHPTI both recommended it and went by their findings to developed a treatment plan. I would also suggest you research Decipher test to gain your own knowledge of this more specific risk diagnosis I would also research and consider asking your urologist and or R/O about a PSMA and bone scan. They too can show if spread outside the prostrate.

If you have a biopsie at 3+4 it means you should be looking at second opinions, more tests, etc. A 3+3=6 ususally means watching. Just be aware that when doing biopsies it is NOT all of prostrate and areas even microscopic that have cancer can be missed. It is why my R/O at UFHPTI did radiation on all my prostrate to ensure all was treated and did not miss an area they biopsies did not find.
Good luck,

rice | @rice | May 5 5:21pm

In reply to @jc76 "@rice My MRI/Fusion biopsies showed 3+4=7. This indicated standard treatment of radiation and hormone as is..." + (show)

I asked about the 3+ 4 and was told it was very small and it just barely a 7

robertmizek | @robertmizek | May 5 5:42pm

In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)

Because of my personal history I would recommend the decipher test. My original biopsy in 2020 came back 3 + 3 low risk. I asked for a decipher test and my urologist said that it wasn’t worth it for low risk low Gleason score disease. He suggested focal therapy so I had one side of the prostate treated with LDR brachytherapy. The only problem was that the biopsy missed significant high risk disease and 3 years later cancer returned with a vengeance. I now have Stage 3 metastatic PCa and genetic testing on my prostate after RP confirms that I never had low risk disease as Gleason 6 doesn’t morph into Gleason 9. Had the decipher test been performed it likely would have shown mutations that would have at minimum initiated a repeat biopsy and reevaluation.

You have to be your own advocate. Hope things go well for you.

toolbelt | @toolbelt | May 5 6:41pm

In reply to @rice "ok I am 72, My PSA has been between 4 and 8. My PSA has always..." + (show)

Please look at my profile for my posts.
The executive summary is;
68, one 3+3, one 4+3, clear PSMA PET, PSA 7.8, Decipher 7.8.

Treatment was SBRT with focal boost to primary lesion and 6 months of ADT with Orgovyx. The SBRT was a breeze and the ADT is no big deal ( 24 days remaining....but who's counting?). Stay engaged, keep educating yourself and importantly ......advocating for yourself. Here are a couple more forums;
https://www.inspire.com/groups/zero-prostate-cancer/
https://www.reddit.com/r/ProstateCancer/new/
https://healthunlocked.com/prostate-cancer-community/posts
Stay Strong Brother!!