1. < Prostate Cancer

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.

shelby29 | @shelby29 | May 6 4:16pm
In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)
@rice

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.

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My doctor doesn't think much of the decipher test. He said I don't need it because I'm a Gleason 8, stage 3b. We are already know I'm very high risk.

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ranger44 | @ranger44 | May 6 4:20pm
In reply to @rice "ok I am 72, My PSA has been between 4 and 8. My PSA has always..." + (show)
@rice

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

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I am 70 years old had fusion biopsy with 23 cores 14 benign, 6 with 70% 4+3=7 and 3 with 40% 3+4=7 I had the PSMA PET which showed nothing outside the prostate. I had a Decipher test which came back 0.38 so low risk of metastasis I have met with Mayo surgeon, Radiation Oncologist, and Urologist regarding focal therapy. My prostate is 50.4 CC and my tumor only .42 CC so about .5% volume. I have decided to do nothing, as the side effects are just not something I want to deal with. The study from the UK which took thousands of men with Intermediate risk PCa 1/3 did surgery, 1/3rd radiation and 1/3 Active surveillance, at the end of 15 years the mortality rate was the same for all 3 groups. I could only wish I had your numbers, remember 3+3 =6 Gleason is not really even cancer. Don't get sucked into the treatment game, it's big business. I am doing the Ketogenic diet, absolutely zero sugar and very few carbs, that starves the cancer cells, I have only been on it 2 months, but my PSA has already dropped from 6.62 to 5.12

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1 reply
robertmizek | @robertmizek | May 6 6:52pm
In reply to @ranger44 "I am 70 years old had fusion biopsy with 23 cores 14 benign, 6 with 70%..." + (show)
@ranger44

I am 70 years old had fusion biopsy with 23 cores 14 benign, 6 with 70% 4+3=7 and 3 with 40% 3+4=7 I had the PSMA PET which showed nothing outside the prostate. I had a Decipher test which came back 0.38 so low risk of metastasis I have met with Mayo surgeon, Radiation Oncologist, and Urologist regarding focal therapy. My prostate is 50.4 CC and my tumor only .42 CC so about .5% volume. I have decided to do nothing, as the side effects are just not something I want to deal with. The study from the UK which took thousands of men with Intermediate risk PCa 1/3 did surgery, 1/3rd radiation and 1/3 Active surveillance, at the end of 15 years the mortality rate was the same for all 3 groups. I could only wish I had your numbers, remember 3+3 =6 Gleason is not really even cancer. Don't get sucked into the treatment game, it's big business. I am doing the Ketogenic diet, absolutely zero sugar and very few carbs, that starves the cancer cells, I have only been on it 2 months, but my PSA has already dropped from 6.62 to 5.12

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I think you made a great case for taking the decipher test. If it comes back low risk with a Gleason 6 AS may be a viable option combined with closely monitoring PSA and watching for doubling time. If the decipher test comes back with a score consistent with high-risk disease however, further investigation and perhaps even a repeat biopsy might be appropriate. You make a valid argument that there is debate whether Gleason six qualifies as cancer, however some studies indicate that many pathology reports often reveal higher Gleason scores than biopsies, even the best Fusion biopsies available today.

I hope you continue to well on your journey with PCa!

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1 reply
ziggypop | @ziggypop | May 6 8:00pm
In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)
@rice

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.

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rice:
There is no reason to not get the decifer test since they will use the biopsy samples that are already taken. I had my biopsy done, tested (Gleason 3+3=6) and a genomic test(low risk ) done at my local healthcare system. I felt uncomfortable with the doctors so I went to Mayo and had Mayo retest the samples. They came back 3+4=7 and intermediate risk of spreading. Go with the best, healthcare system adn tests and make your decisions from there.

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billfarm | @billfarm | May 6 9:54pm
In reply to @robertmizek "I think you made a great case for taking the decipher test. If it comes back..." + (show)
@robertmizek

I think you made a great case for taking the decipher test. If it comes back low risk with a Gleason 6 AS may be a viable option combined with closely monitoring PSA and watching for doubling time. If the decipher test comes back with a score consistent with high-risk disease however, further investigation and perhaps even a repeat biopsy might be appropriate. You make a valid argument that there is debate whether Gleason six qualifies as cancer, however some studies indicate that many pathology reports often reveal higher Gleason scores than biopsies, even the best Fusion biopsies available today.

I hope you continue to well on your journey with PCa!

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I never was offered decifer test. 15 cores all 5plus 4 or 4plus5 sort of rushed into rp. Pet scan indicated extaprostatic extension . Surgery path Gleason 9 seminal vesicles imvaded positive margins and bladder neck invasion and 6 nodes involved . Adt cancelled recurrence 14months psa undectable. Does anyone think decipher test can give me valuable info at this late date???

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2 replies
robertmizek | @robertmizek | May 6 10:41pm
In reply to @billfarm "I never was offered decifer test. 15 cores all 5plus 4 or 4plus5 sort of rushed..." + (show)
@billfarm

I never was offered decifer test. 15 cores all 5plus 4 or 4plus5 sort of rushed into rp. Pet scan indicated extaprostatic extension . Surgery path Gleason 9 seminal vesicles imvaded positive margins and bladder neck invasion and 6 nodes involved . Adt cancelled recurrence 14months psa undectable. Does anyone think decipher test can give me valuable info at this late date???

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My opinion (for what it is worth) is that either the decipher test or some other genetic testing can identify the type of mutation involved with your cancer. Certain mutations respond very well to Advanced drugs like Keytruda. Genetic testing can also reveal what the tumor burden load is whether you have microsatellite stability or not. Knowing these things can be helpful in determining other treatment options should ATT and RT not result in a full remission.

All the best to you while on your journey with PCa.

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bens1 | @bens1 | May 7 7:10am
In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)
@rice

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.

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All good advice. Absolutely get the Decipher test. I had the Prolaris test first but then had the Decipher test based on an RO's advice in New York City and my radiation oncologist in Florida, both said the sampling size is larger with the Decipher test.

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billfarm | @billfarm | May 7 6:59pm
In reply to @billfarm "I never was offered decifer test. 15 cores all 5plus 4 or 4plus5 sort of rushed..." + (show)
@billfarm

I never was offered decifer test. 15 cores all 5plus 4 or 4plus5 sort of rushed into rp. Pet scan indicated extaprostatic extension . Surgery path Gleason 9 seminal vesicles imvaded positive margins and bladder neck invasion and 6 nodes involved . Adt cancelled recurrence 14months psa undectable. Does anyone think decipher test can give me valuable info at this late date???

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Is. Genetic testing part of decifer? Was mulling on immunotherapy at a private clinic in phoenix. They genetically tested the pc and would try to create a custom vaccine to match it . Sounded plausible til my friend who also has cancer discovered that their immunotherapy drugs were at best 12-18 percent Sucessful and while intriguing not quite ready for everyday acceptance.

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gently | @gently | May 7 8:26pm
In reply to @rice "My first biopsy they found 3+4 in less then 2% of one core that was on..." + (show)
@rice

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.

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Decipher is genetic. Called somatic testing it tests the tumor mutations. It is different from the hereditary testing, which can also be helpful.
Immunotherapy with specificity to each patient's tumor is intriguing.
I would want the testing in case of metastasis. I hope the information will never be useful to you. You have been through enough already.
But it may help you with vigilance and with a determination about future ADT. Plus you'll be contributing the the knowlege that may someday make prostate cancer powerless.
https://decipherbio.com/decipher-prostate/physicians/grid/
Glad you are well.

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