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Why are urologists dismissive about Decipher?

Prostate Cancer | Last Active: 5 hours ago | Replies (29)

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@edtrucks

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.

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Replies to "Breadmaker, I was curious about your PSA and MRI results compared to mine because while I..."

Edtrucks -

My first urologist - he's now retired - put me on Active Surveillance. When I got my 3+4 with my new urologist, I had been on AS for six years.

So, in my case - and it matches my personality - it's inertia and analysis paralysis. Not any deep thinking or research on my part.

Also, I had joined a virtual support group that was just about all men that had advanced in their treatment, and some of their stories heightened my anxiety about treatment. I should have realized that I wasn't dealing with a general population of those treated, but a self-selected group that wasn't happy with their results.

I now attend an ancan.org support group. They have their groups split up by category - Under 60, Military, Low/Intermediate AS, Low/Intermediate (discussing treatment) and High Risk.
https://ancan.org/prostate-cancer/
I hope more support groups do this in the future. AnCan is the only group that I'm aware of that does this.

You made the right decision for you and you can now put this cancer in the background and focus on living!

La dolce vita.