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Why are urologists dismissive about Decipher?
Prostate Cancer | Last Active: Jun 7 4:39pm | Replies (36)Comment receiving replies
In my case, the R/O recommended Orgovyx for my intermediate unfavorable prostate cancer prior to starting radiation. I went into that meeting determined to resist hormone treatment at all costs. He said, "I've never had a man sit there and tell me he wanted hormone treatment." So he offered the Decipher test, as it would show whether or not I needed hormone treatment. I agreed, and Decipher came back High Risk, so I started the Orgovyx and am glad I did. I credit the R/O for getting me over my initial objections and I credit Decipher for confirming in writing that I needed the hormone treatment. That' s my story.
Replies to "In my case, the R/O recommended Orgovyx for my intermediate unfavorable prostate cancer prior to starting..."
I have read many comments in this forum that if a Decipher score is high, then ADT may be necessary. I didn't doubt, I took it for granted that this is correct.
But because the discussion topic is "why are urologists dismissive about decipher," I decided to check if a possible reason can be that there is an alternative or equivalent test?
It is therefore only by chance that I found out: Decipher can guide a decision if adjuvant radiotherapy is necessary, as an addition to a primary treatment like surgery.
Conversely, Prolaris and Oncotype DX both predict the risk of biochemical recurrence; the latter can help determine whether hormone therapy is beneficial.
I was somewhat unhappy that my care team didn't order a Decipher test before advising me to go SBRT + ADT/Orgovyx. Not anymore because it wouldn't have been a factor in the hormone therapy decision; Oncotype DX would.
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@brian5837 I also credit my RO for putting me on Orgovyx. I was initially offered the once in 3 months ADT injection but I said I was anxious about its side effects that I have read in this support group.
The urologist who did my biopsy also classified me as unfavorable intermediate, Gleason 7 (3+4), positive on 8 of 14 cores.
He presented me the options to have either SBRT, RARP or open surgery (the latter he does with another surgeon in a regional hospital, for the other two he referred me to a cancer center). After comparing the side effects and risks listed in the consent forms for RARP and SBRT, and considering my family's concerns/worries about surgery at my age, I chose SBRT with Orgovyx starting two weeks before my treatment Aprl 9-21. My oncologist said that we would see if I could discontinue Orovyx after 8 months or a year.