Why are urologists dismissive about Decipher?

Thanks for all the advice and recommendations. I will plan to see an oncologist and urologist at OHSU University. My Decipher was .85 and said I have a 6 percent chance of metastasis in the next 10 years. I didn't realize that radiation might be a better option. Hopefully the new team at OHSU can help me out but I realize my chances don't look too promising now.

That is very good plan 😊 and your chances are very promising. If you treat cancer early it can be completely curable 👍🍀

neiwhi, there are three different oncologists you should talk to a medical oncologist. a radiation oncologist and a surgical oncologist. Meanwhile check out some of the videos https://www.youtube.com/watch?v=ZpK3JhVUNDk and check out this little video on MRI guided radiation https://viewraysystems.com/for-patients/how-mridian-works/prostate/
Chances are you'll fare very well. The treatments for prostate are have gotten quite good.

Au contraire - your chances of living a long life are excellent! Your plan for consultation going forward is a good one and will help you decide on the appropriate treatment.
BTW, don’t be too hard on your urologist. He sounds pretty current and was probably very surprised by your Decipher score. Who knows how many patients he saw that day - or before your conversation - who refused treatment or advice? He’s only human and his frustration came boiling to the top. I was in healthcare for many years and often asked my patients in frustration “Why do you even come here if you know more than me?”
That said, he should have recommended further consults and given you more options for treatment. Best,
Phil

Thank you Sir for the encouragement and insight.

I watched both. It looks encouraging.
Thank you 😊

Thank you for the encouragement 😊

I noticed the same thing. I first learned of the Decipher test a good month "after" my DaVinci Robotic-assisted RP. I posted a few things here, and nearly everyone asked: "What is your Decipher Test score?" I had no clue what they were talking about, so I researched it. I contacted my urologist asking whey he didn't order it? His first reply was that he tried, but that my insurance wouldn't pay for it." I told him that I was upset...upset that he never told me that he supposedly got an insurance denial, which would have offered me the opportunity to pay cash for the Decipher test. I got not reply (this was all "patient portal messaging"). I thought: "Wait a minute, at the time of biopsy, I had Medicare as well as being on my wife's outstanding health benefit plan. Fast forward a couple months to the point I was now divorced, but still on Medicare obviously. I contacted my Medical Advantage Plan, who said that the Decipher Test is approved for payment. Now I was REALLY ANGRY. So, at this point I am post-op having had my prostate, seminal vesicles, and vas deferens removed. I messaged my urologist back that I want the Decipher Test. His first response was " we don't need it now, we know everything we need to know based on the surgical pathology report" (perineurial invasion, EPE, surgical margins, left seminal vesicle invasion, and cribriform glands). I said, "nooo...we DON'T know everything we need to know...we don't know risk factor and probability of recurrence or metastasis and when." I "directed" my urologist to order the Decipher Test on my prostate tissue (probably better than doing it on biopsy core samples). So the test is ordered, and I am three weeks into the six week turn around time for the results. So...I totally agree...I guess there is a mindset or school of thought by some urologists that the Decipher Test is not worth the time or effort, but I don't know why, and of course, a urologist would never share their reasoning. I am still very angry that he claimed that my insurance would not pay for it. I think that was a convenient lie for the sake that he either didn't want to order the test or that he forgot to order the test.

In my case I did the Decipher and Artera AI. My Decipher score is high .63 just over the bench mark. My Artera came back low risk, that indicates no clear risk reduction with adt. My RO wants me to go on hormone therapy for 6 mths. I’m hesitant based on the Artera score. Which one carries more weight?

The Artera AI was just approved last month by the FDA.. The decipher test has been around for a lot longer and many of the documents I have seen use it as a guideline for when treatment is needed.

Follow your doctors advice, I’d like to at least get a better chance of not having a Reoccurrence soon.