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Recently diagnosed stage 1 prostate cancer

Prostate Cancer | Last Active: Nov 21, 2025 | Replies (31)
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Thank you. Yes the 0.78 Decipher score is in the very high risk category. And the test was done from the same core samples. I am concerned with the inconsistency between the Gleason and decipher. I wonder if something else may be driving the Decipher or, as you mention, perhaps it’s the subjectivity problem with the Gleason. I plan on discussing this inconsistency during my next consult and inquire about sending my results to a center of excellence for another opinion considering the odd results. Also thinking of inquiring about a Pet Scan to see if there is anything else there that may be the driving factor.

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Replies to "Thank you. Yes the 0.78 Decipher score is in the very high risk category. And the..."
Jeff Marchi | @jeffmarc | Nov 17, 2025

@kyndats
Did you have a fusion biopsy? That involves using an ultrasound with an overlay of the MRI so that they Tumors can be successfully sampled. Normally, they would take three samples from each tumor. PIRADS 4 Is unlikely to come up with nothing. You also want a transperennial Biopsy, which can get to more of the prostate than the transrectal biopsy.

When they do a biopsy, they only get one percent of your prostate. They could’ve missed something.

With your high decipher score, I would not want to just let this go. Talk to your doctor about how the biopsy was done. Is it possible that another biopsy is needed?

A Gleason 6 is not normally considered an adenocarcinoma, in fact, many doctor say it is not cancer at all. Maybe you need a second opinion on the biopsy.

Either of these doctors are considered the experts in doing second opinions

Dr. Epstein biopsy
https://advanceduropathology.com
Dr. Zhou

Send an email to Ming.zhou@mountsinai.org to inquire about a second opinion and ask for his specific instructions for the process.

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rotate | @rotate | Nov 17, 2025

@kyndats I also have conflicting DECIPHER and Gleason: low risk but Gleason 9.

That is unusual but not unheard of. Gleason and Decipher measure different things, or there’d be no point in both tests.

My RO had no problem with it.

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