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Why are urologists dismissive about Decipher?
Prostate Cancer | Last Active: 5 hours ago | Replies (29)Comment receiving replies
Edtrucks -
My PSA is 4.4. I'm doubling the lab number of 2.2 since I'm on Finasteride.
My MRI in 2018 had one lesion with a PI-RADS of 2.
My MRI in 2022 had an odd report of "category not applicable, no category 4/5".
I should have asked about that last report but didn't. Maybe no lesion? I'm slowly learning to pay more attention to the reports, to ask questions and to be a better advocate for myself.
What is anxiety provoking for all of us is not knowing what is the definitive course of action. Instead it's a risk assessment and we as patients need to be active participants.
If I'm following properly you haven't had a Decipher test, so I'd suggest you get one.
Then check out -
https://connect.mayoclinic.org/discussion/using-decipher-grid-report-to-help-guide-your-treatment-decision/
Hopefully, that link works for you.
It's a post that @handera started titled "Did Decipher GRID report help guide your treatment decisions?".
Decipher is a genetic test. It's done on the core with the highest cancer.
There's a study called Promise that will give you a genomic report. This will be on you - body and soul. Well, just body. 🙂
The Promise study is closing soon but you might still be able to participate - no cost to you.
https://connect.mayoclinic.org/discussion/promise-study-registry-of-pca-genetics-and-outcomes/
All the best to you.
Replies to "Edtrucks - My PSA is 4.4. I'm doubling the lab number of 2.2 since I'm on..."
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Breadmaker,
I was curious about your PSA and MRI results compared to mine because while I made the decision to have radiation, I struggle with that decision. Did I really need to go to that extreme?
(I am on my 24th session of 28) Like you, I had only one biopsy result of 3+4 (less than 5%). I considered AS, but the combination of the doctors telling me that any Gleason 4 should be dealt with (really?), my 8.4 PSA, (I struggle with the inconsistencies of what is a high PSA value) the thought of more biopsies, (barbaric at best) plus the upside of not having to have testosterone therapy with the radiation due to the 3+4 favorable rating, supported my radiation decision. It was the least invasive, and frankly I would like to move on from the cancer.
Surgery to me was out of the question, especially with the minimal cancer found and the side effects of the procedure. It was difficult as you mentioned to have to determine our own course of action. My doctors were not recommending AS. I did not have a decipher test. I asked my urologist about it and he brushed it off. I don't think it would have made a difference in my decision.
I'm in no way suggesting you take the same path as I did, just sharing my experience. I like to believe the statement that more men die with prostate cancer than from it, and if true, that would mean making the right decision to not remediate. If I found 10 people that had a similar prognosis to mine, and did what I did, I guess I would be more secure in my decision. Your prognosis was very close with the biopsy Gleason results, but your lesion ratings and lower PSA were significantly different, if that in fact truly makes a difference. Thanks for sharing your information and I hope you the best in the choices you make.