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@hoover58
I will be careful with my words here but my experience with Mayo Jacksonville urology department was not positive. I ended up going through Patient Advocacy.
The urologist I saw was one of those that said, "you won't die of prostate cancer, it will be something else." You will also see another post I posted where the same urologist wanted to do my biopsies via rectal. And then said it has a 2% more chance of infection but "you would only have to spend a couple of days in hospital if you did get it."
I did not accept his way of doing it and challenged it and had my cardiologist get involved who advised absolutely no issues with me having anesthesia.
I advised my PCP (Mayo) if he needed to refer me again to a urologist, I did not want to see the same one.
Mayo radiology/oncology was the division that gave me the information on Decipher and offered it to me to make a more specific diagnosis of my cancer risk. My decipher score came back at low risk where my biopsies had come back as intermediate.
I have posted many many times that I strongly suggest getting additional tests like Decipher, PSMA, bone, etc. to help clarify and get more specific information on your cancer diagnosis. AND get a second opinion.
Replies to "@hoover58 I will be careful with my words here but my experience with Mayo Jacksonville urology..."
I read with regularity patients in the USA having an anesthetic when havingg a biopsy . This is the exception elsewhere . He in Canada I have yeet to meet anyone who had an anesthetic .
Additionally the USA , THE WORLD LEADER IN MANY FIELDS , ARE BEHIND IN PERFORMING Transperineal Biopsies . In fact several countries have banned the TRANSRECTAL procedure and a select few Urologists in the USA will no longer perform the outdated transrectal . In addition to the lower risk of infection . The transperineal has a better chance of reaching difficult to get at leisons , typically the ones a Urologist cannot detect on an DRE .
With respect to the Decipher Test . My recommendation as a first step after receiving your biopsy pathology report is : " Get a 2nd and 3rd opinion of the Gleason Score ."
I'm speaking of experience here , if you read my prior posts .
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I think that's good advice. I'll post again what my radiation oncologist told me.
He said that Decipher is an important way to avoid overtreatment: instead of assuming a worst case by default, it makes oncologists more confident in recommending lighter treatment options or surveillance in some cases for early-stage cancer.
For advanced prostate cancer, however (as in my case), he said Decipher wouldn't add much value, because there's no point trying to figure out how likely it is to metastasise when we know it has already happened. It would be like having a system to predict the result of last year's Superbowl (my words, not his 🙂 ).