Decipher is a biomarker (genomic) test that looks for mutated genes, proteins, and tumor markers that tell more about the prostate cancer. These tests include Decipher, Prolaris, OncotypeDX, and many more. Knowing this may help with treatment decisions.

Genetic (germline) test tells you which genes related to prostate cancer you have inherited from your parents. (Like BRCA1/2, ATM, CHEK2, HOXB13, MSH2, etc.) Knowing this may help with treatment decisions.

If the 8(4+4) cancers in your prostate don’t exhibit enough PSMA to light up a PSMA PET scan, then if there are other prostate cancers elsewhere, those also might not exhibit enough PSMA to light up a PSMA PET scan either. You would want to know this. This is certainly worth discussing with your medical team. (An 8(4+4) should’ve lit up the PSMA PET image like a Christmas tree.)

ADT+RT is so advanced these days that results are statistically equivalent to prostatectomy. The purpose of ADT is to lower testosterone to starve/weaken prostate cancer cells, making them even more susceptible to death due to radiation damage. With your 8(4+4), they would likely recommend 18-24 months of ADT. (I had 28 sessions of proton radiation + 6 months of ADT for my 7(4+3).)