PSA/MRI not too bad, Biopsy not too good. What??

Cribiform and IDC would have been shown on the report.

On the cribriform and ultraductal issue you can ask your attending doc outright. My guess is they would have said something if they saw any.

It seems to me that you may want to really consider getting the thing out ASAP.

Once it's in a pathologist's hands you'll get the real skinny. And now with Decipher they can use the tissue to come up with a good prognosis on aggressiveness etc. Further if they get in early enuff they can spare one or both of your erectile function nerve bundles.

The operation is quick and you're on your feet in a day or two. Bowel movements can be agony for awhile tho.

If you just go back and read the litany of all the rigormoreroll you've been thru to date in having it stalk you and w your family history, I'd just get it out.
Then you'll know how much
further or little treatment you'll need in the future.

If it's slipped out of the prostate capsul, you'll find that out. And that's not a death sentence. They can do a lot to cure even then.

But they have to first know and a prostatectomy in my opinion gives the most info..

Recall an adage constantly ringing in my ears as an Infantry 2nd Lieutenant going thru Infantry Officers Basic at Ft Benning enroute to Nam-

"Lieutenant-
Always bring me the bad news first.
Good news takes care of itself."

Has your doc talked to you about the possibility of a cure with a prostatectomy?

Good luck!!

Actually, the PSE test could be more important than a decipher test. The PSE test Is 94% accurate in telling you whether or not you do have prostate cancer. You have had a lot of biopsies, but it’s designed to prevent biopsies if it doesn’t find prostate cancer.

If it does find it, then treatment is important.

Huh? Doesn't this guy already have histologically proven cancer? A low-grade, indolent form for sure, but cancer nonetheless. He isn't concerned about whether or not it's there. His concern is whether it should be treated or watched.

great info, thank you! You were diagnosed at about the same age as I was. 21 years of AS is amazingly great, I had hoped to get many more years myself.

It will be interesting to see what next steps are recommended by my Mayo Team, but seems like a PSMA would make sense for me.

Glad you have done well all these years and hoping your Decipher results are good news. Once you get the Decipher results, please share here if you would like.

Thanks, again!

If you are interested in AS for 3+4 attached is the first page of a recent journal article discussing pertinent studies. The full article can be readily obtained on the internet at no cost. You tube contains many excellent videos by Dr. Mark Scholz. It takes a lot of time and research to figure out all this stuff.

The thing is, they are relying on the fact that The Gleason is so low that maybe they can keep going without doing anything. The PSE test could quash that expectation. Wouldn’t hurt to have a decipher test as well.

Maybe I am misunderstanding the PSE. I thought it combined PSA level and a PC epigenetic marker to improve the likelihood that a "positive" test is actually associated with the presence of cancer. (94 vs 50 % accuracy?) Does it actually provide information about the severity/aggressiveness of the predicted cancer? I thought its main purpose was to help men decide whether or not to have a biopsy for the first time. If someone already knows cancer is present, from a prior biopsy, how does the PSE help. None of the articles I have access to explain this.