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pT3b - What was your Decipher Score?
I just received my Decipher Test Score of 0.50. I am a pT3b cancer category with the following: EPE, Surgical Margins, Left Seminal Vesicle invasion (slight); and Cribriform glands.
I am interested in knowing the following from you:
1. Your original biopsy Gleason Score.
2. Your post-RP Gleason Score, if it changed on post-op surgical pathology review.
3. Your post-RP cancer category (Type 1, Type 2, etc. and any pT2 or pT3a, or pT3b, type of further-defined cancer type).
4. Your Decipher Test Score and when it was done (on biopsy tissue or post-surgical prostate tissue)?
What I am trying to do is view a range of Gleason Scores vs Decipher Test Scores vs Category/Type of cancer that your surgical pathology report said you are.
My Decipher Test Score said that I have a 1.9% chance and a 4.8% chance of metastasis at 5-years and 10-years, respectively, and a 5.4% chance of metastasis at 15-years. The second page of my report on the graphical chart has me at 4.8% risk of metastasis at 10 years ("48th percentile"). I am squarely in the "Intermediate Risk" Category, despite what are seemingly the favorably low percentages of possible metastasis. It says that such Intermediate Risk patients have moderately aggressive tumor biology.
BTW...the last risk score for me after 15 years, was "18% at RP". "RP" is apparently "Risk Adverse Pathology" per what is written below the 18%, but they don't really explain "Risk Adverse Pathology". Does that category wipe away the others because "Risk Adverse Pathology" is any of what I mention above: EPE, Surgical Margins, Left Seminal Vesicle invasion, and Cribriform glands? In other words, because I have any/all of those microscopic features, am I now at 18% risk of metastasis, and if so, "when"...at 5 years, at 10 years, at 15 years, or after 15 years, or "at ANY TIME"?
Thank you.
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HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
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Original biopsy Gleason was 3+4 after surgery it was 4+3. I was T2c. I have BRCA2 which prevents my DNA from correcting genetic errors. Type 2.
Decipher didn’t exist in 2010 when I had the prostatectomy.
Short history
In 2010 I was 62 and a biopsy showed Gleason 3+4. Had surgery, after surgery they told me it was a 4+3. It was only stage two. 3.5 Years later it came back and I had ADT 2 months before 7+ weeks of radiation. 2 1/2 years later it came back and I went on Lupron. I became castrate resistant 2.5 years later and added biclautamide. 1 .25 years later went on Zytiga, which kept my PSA down for 2 1/2 years., After some AFIB Issues I switched over to Nubeqa, The last 22 months I’ve been undetectable. I became stage four about six years ago, had a metastasis on my spine zapped. I did not find out I was BRCA2 Until four years ago.
I’ve had four reoccurrences and I’m just waiting for my next one, with BRCA2, it’s inevitable.
Hi rlpostrp,
1. Original biopsy Gleason Score: 4+4
2. Post-RP Gleason Score: 4+3
3. Post-RP cancer category: pT3aN0M0, AJCC stage IIIB, Grade group 3
4. Decipher Test Score on biopsy prior to surgery: 0.84 (high risk)
Before surgery I was a Gleason 7 with high risk perineural invasion detected
After surgery was pT3b N2. MO Gleason 9
So two positive lymph nodes one with extra nodular extension detected
So I went to advanced aggressive
PET scan negative
Did radiation 40 sessions and have been on ADT for 18 months now Psa undetectable but tested one just jumped into the normal range in the past three months
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Hug
1 ReactionMy original Gleason was 3+4
My Decipher was .25 on 11/30/22, .9 at 5 years, 2.2 at 10 years and 3.9 at 15 years
My Prolaris was 2.4%, on 11/7/22, with active treatment (similar to Decipher but they used a smaller dataset than Decipher)
Not sure if you wanted to make any comparison to radiation, which I had, given you had an RP
The highest possible decipher score is 1. Not sure where you’re getting the decipher numbers you’re quoting they must be for something else.
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Hug
1 ReactionSince the highest Drcipher Test score can only be 1.0, I believe the numbers you write are your “risk of metastasis” percentiles at 1, 5, 20, and 15 years, respectively, based on your initial Decipher Test score of .25 correct? If not, I am confused I guess.
@rlpostrp
I have attached a copy of my Decipher test.
Hi Jeff,
I don't know too much about the decipher score, but can it change after surgery or as years progress?
1. My pre-op Gleason score was 3+4
2. My post op Gleason score was 3+4
3. Post op cancer stage is pT3b with SVI, and w/lymphovascular and perineural invasion. Surprisingly, all margins negative!
Lymph node dissection was not performed as planned since my post-TURP prostate was so full of inflammation, it was very challenging to work with. It took so many more hours to complete the surgery that they were not to able perform the bilateral lymph node dissection as planned. They only managed to do one which was negative.
4. My urologist ordered Decipher test yesterday, and PSA test 2 months after the surgery which took place on September 2nd. I have a follow-up meeting with my urolgist on November 10th. I believe the major decison at that time is if and when to start additional treatment: right a way, or wait for PSA to rise.
GPS score before surgery was 47, which suggests a very aggressive biology of my porstate cancer.
I could be wrong (and I hope I am wrong) but my Decipher test will probably show a very high risk disease that will require additional treatment at some point, maybe sooner than later.
You are correct, but since the maximum number is one and everybody else is between .01 and one, your numbers make no sense