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Treatment Decision - Radical Prostatectomy versus Radiation Therapy
Prostate Cancer | Last Active: Oct 19 10:23am | Replies (57)Comment receiving replies
More data this morning to throw into the mix. RO order a biopsy based Decipher Genomic Classifier test in support of potential participation in a clinical trial. Results indicated a Decipher Score of 0.88 which puts me in the high risk group for aggressive tumor biology. Everytime I turn around I seem to get more news that pushes the risk higher and higher. This is one crazy disease. Even the treatment decision process sucks the energy out of you.
Waiting for my RO and Surgeon to weigh back in on how this might impact options or standard-of-care going forward.
Replies to "More data this morning to throw into the mix. RO order a biopsy based Decipher Genomic..."
Doug,
Yes, sucking the energy out is right! It was the biggest decision I ever made. I should say "we" because my precious wife suffered through each decision point as my sounding board. There were periods of what I called "analysis paralysis" and then I'd break through.
Now as for your decision, one size doesn't fit all. I'm talking sex and incontinence mainly. You have to "know thyself" as some famous Greek said. So for us, we took the "get it out of there" option. I don't believe you have given your age but I had surgery at 78 years old and would do it again in a heartbeat. My ultra-sensitive PSA test at 3 months was 0.006 and time will tell if they got it all. I'm down to 1 pad per day and improving and ED has required adjustment but is tolerable.
Here is a link to my COMMENT with my detailed story under the heading "Is 76 years too old for surgery" or words to that effect.
Best wishes to you, whatever your decision. You CAN do this!
https://connect.mayoclinic.org/comment/1075893/
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Well, from what you were saying before, this high decipher score will result in you having to be on ADT after having radiation. Might make sense to do it now, that would stop your cancer from spreading and growing and usually shrinks it a little before radiation. Usually the RO wants that before radiation. Was it mentioned?
Did you do something about genetic testing, or ask the doctor about it? That would also be a factor in what you should do surgery vs radiation.
Just realize that there are a lot of things that can be done in your future. Prostate cancer is not usually a death sentence. There are many drugs and treatments that you can take that stop it from growing and can give you a long life. My Gleason was 3+4 after biopsy, but I had surgery and they found it was actually 4+3, that was 14 years ago , and two years ago, I found out through the genetic test that I have BRCA2 which prevents the DNA from making corrections when there are errors, that’s what causes my cancer to keep coming back, but I’m still around after almost 15 years. Gleason number changes are not unusual your 3+4 may not be a 3+4, I know a lot of people that found out higher numbers after prostate surgery.
There is a long future ahead for you, don’t think you only have a short time left. Many of us worried about that and are around a long time after diagnosis.