If you have a prostatectomy, do they usually do a decipher test?

John, any drug has side effects, so please don’t be afraid of Orgovyx. It’s a drug that stops PCa in its tracks and could save your life.

Does it mean that radiation needs to be planned after surgery with Gleason 9?

Some people need that, Your doctors are the ones to talk to about it. Some doctors will delay it for a while. Some want it right away. If you have surgery are there clean margins, If not, you may have radiation sooner.

I asked my urologist about decipher testing in my case.
Since I already decided on a treatment (prostatectomy ) and we know aggressiveness from biopsy, the decipher testing wouldn’t really provide much value to me. However, depending on how things go with the RP, if I need more treatment, they feed all my various attributes (ex. Gleason score) into an algorithm that helps guide the next phase of treatment.

im in exactly the same boat. pathology showed IDC and cribiform. But i knew that going in. My pre-prostatectomy decipher was 93, which is why i got the surgery. So constant vigilance and aggressive treatment are SOP going forward. i had clear margins, LN and SV, but an EPE.
Im in the process of exploring aggessive treatment options, as I think it is just a matter of time. looking at ultrasensitive PSA testing (uPSA) to more quickly identify PSA changes, maybe getting a PSE (ids cancer fragments in the bloodstream), and looking types of radiation/hormones I want to use if and when a recurrence occurs. i am tyring to find a RO that really is expert in more aggressive cancer and treatment. if you know of anyone, please let me know. Seems like most of the peoiple i talk have limited experiecne in IDC/Cribiform, and appropriate treatment plans.

Based on all the posts here, certainly doesnt seem like PC has a 98% cure rate. Of course, i guess those that have a long history of clear PSA tests arent reading this!

i would request it, as the results will either 1.) give you a greater sense of comfort is you are low risk; or 2.) provide a clearer treatment path if you are high risk. It seems like it should SOP for all COE.

So far my psa has remained low so I haven't had the need to look for an RO (yet) so I don't have any recommendations for you. I had my surgery at Mayo Phoenix and was very pleased with them so if my PSA starts rising I'll probably continue getting care from them. But it hasn't happened yet so who knows what I'll do if and when it happens. Best wishes.

Hi, my husband has cribriform and IDC and will have RP next month.

I read a LOT about cribriforom and IDC ,not only regarding treatment options but about their biological and morphological characteristic and if I could sum up all of what I have read in a simple statements they would be :

1) those kind of formations were just recently being recognized as special entities with separate and often negative implications

2) each of those 2 have subgroups ! There are some cribriform that behave almost the same as any other cancer cell and have the same predictions and than there are large cribriform formations that are pretty aggressive. Also, they can be in dense layer or loose layers . Dense are considered less favorable.

3) IDC also has subgroups , some have thick basal layer and some thin - again different implications

Until recently neither "entity" was even mentioned in pathological reports, so there is very little data to fall on from previous generations of patients and that is why there is no separate protocol developed for treatment of those particular types of cells. But, everybody agrees that having those is not a good news. At the same time not everybody that have them will have unfavorable results depending of what subgroup one has and of course of the spread that already happened or not , etc.

4) there are some studies that showed that cribriform somehow can evade radiation as well as IDC so RP is often suggested as the first step. Otherwise, if radiation is chosen it also can have very good results but the boost at the end of the therapy is often suggested in attempt to kill the resistant cribriform cells. One also has to be aware that when one has radiation of the certain area that is it. One can not have the same area radiated twice.

5) both cribriform and IDC are aggressive in nature and the most aggressive treatments should be implemented as initial treatment.

Of course, this is just my compilation of results of some research papers and you should do your own reading and decide for yourself what is the best way forward for you. Wishing you the best of luck with whatever you decide.

I requested a decipher test after my RP. It showed a higher risk. So far I have had 5 PSA tests, all < 0.01. My doctors have said I do not need any additional treatment at this time. Hope and praying for more of the same in the future. Best wishes!