Decipher Test

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countries have banned the TRANSRECTAL procedure and a select few Urologists in the USA will no longer perform the outdated transrectal .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 .

My advice : Get a 2nd or 3rd opinion of your pathology report . YOU MAY FIND A CONFLICT IN THE GLEASON FINDINGS . If you read my prior postings - you will understand why .
Biopsy # 1 ALL TARGET AREA CORES NEGATIVE .
Biopsy # 2 All 6 Target area cores Gleason 3 + 3 = 6 , 2nd Opinion : ALL UPGRADED TO Gleason 3 + 4 = 7
3rd Opinion : 4 Cores Gleason 3 +3 = 6 2 Cores Gleason 3 + 4 = 7 Take your pick .
Both biopsies were TRANSPERINEAL MRI Fusion Biopsies . The 1st a Five Core in the Target area . The 2nd a 16 core , with 6 in the target area . Only cores in the target area showed cancer . I am currently on active surveillance
IF I WERE YOU -- I WOULD CHANGE UROLOGISTS FAST .

Correctamundo!! I don’t know why any doctor would leave ANY prostate tissue IN with that kind of decipher score. Get away from this a**hole pronto!
Look, Mayo is a great system but even great systems have clunkers in them. When I went to Sloan I was seen by the senior attending RO. He gave me a Prostate exam - I had it removed 5 yrs before - and almost killed me….I literally screamed - and he laughed and told me that I would need 39 sessions of radiation. A year later after many PSA’s I returned to start treatment and was seen by a new doctor.
“Where’s Dr F***face,” I asked. “Oh, he’s gone…thank God! But you didn’t hear that from me!”
“I didn’t care for him,” I said…
“No,” he replied, “not too many people did…”
And I then got 25 treatments - the newest research indicating it’s on a par with 39 and less time needed. So even the BEST of the best hospitals have losers on staff. You wouldn’t let an inept car mechanic work on your car - don’t let an inept physician treat your body!!

I am 3+3 in one core and 3+4 in another core. I got the decider test but they were only able to test the 3+3 core because the 3+4 was too small to test. I was very disappointed because it was the 4 I was worried about

@rice
Could you do another biopsy?
Speaking for myself I would want the Decipher test on the 3+4=7 as that is the one with most possible cancer aggression. The urologist doing your biopsies should have taken enough tissue to do this but not being a surgeon or urologist maybe there was a reason it was done to small.

I am not sure where you are going for treatments but would asked about another one or consider getting a second opinin from a different provider and explore another biopsy with need to address the area that came back 3+4=7.

I know this is redundant but my Decipher changed my treatment from Radiation and hormone treatments to just radiation. So you can see why I am a real promoter of this test.

Glad you got the test. My experience at Mayo Rochester was completely different. They mentioned it, I kind of wondered if it might help in my decision, and BAM, he ordered the test using the tissue taken from an earlier biopsy by a doctor in a different state. Mayo took care of all the details of getting it done. That said, I'm not sure the test is a big factor. My risk was just in the low range (.42) but within a year the cancer growth had exploded to push hard against the prostate wall. So, went in to burn it out.

Thank you for this insight. Could you please offer information on how long it took for you to get the Transperinial biopsy appointment scheduled at Mayo Jacksonville? Is your Urologist with the Mayo clinic Jacksonville or were you referred to Mayo from another Urologist? I wonder if it makes a difference.

@esteiny
As I mentioned my urologist wanted to do it transrectal. I said no and his reason was my cardiomyopathy. I got my HF and cardiology involved and they advised him there is not an issue with anesthesia. In my opinion it was just him trying to do it transrectal and not the additional involvment when done transpernial under anesthesia.

How long to get appt.: It took about 2 weeks to get the appointment after we resolved the type of procedure (only a couple of days as my HF doctor is Director of Heart Failure and Transplant and said no problem.
Is your urologist with Mayo: Yes
Wonder if it makesa a difference. Don't know but would in my opinion be restricted to referral for tests coming from Mayo doctors. I know second opinions are done there all the time but again that would be with a Mayo doctor.

Thank you very much for your reply. This is good and helpful information.

Happy holidays!

Hi @colleenyoung - Thought I would provide an update now that I have my Decipher test results back. Unfortunately, my number came back at .78 which is quite high. So I'm now in that grey area with low clinical numbers (Gleason 3+3, low volume, most recent PSA of 3.8) and a very high Decipher genomic test. Have a few more genomic tests outstanding that will be looking specifically for gene mutations and have follow ups scheduled with a couple of different doctors before deciding on a treatment plan.