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Does Decipher gene sequencing look at healthy & cancer cells?
Hello all, my Dr called with my decipher results. Thank you all for suggesting the test, my Dr had no problem ordering it. Previous to this we did a Prolaris test. He likes them both and at any given time one can be preferred over the other depending on the latest update. My back story: Gleason 6, 3 cores positive only one with less than 10%, the others 1%, strong family hx, my father passed away from Pca. I’m on AS now but it’s kind of a grind mentally and it’s only been 4 months.
Anyway my question is, when decipher looks at the gene sequence is it just the cancer cells or healthy cells as well. Meaning, do the healthy cells tell the story of potential progression as well as the cancer cells? My Dr didn’t say anything about unique dna or path finding. He gave me the decipher number, .29 as well as odds of METs in 10yrs, detection in 15yrs and if removed the odds of Pca somewhere else. Thank you all, keep driving forward!!
Pete
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The information you have provided indicates AS is the best choice.
You can provide more info for better responses.
Age
Did MRI show any lesions?
PSA
You are being proactive in obtaining information. Hopefully, this will provide some peace of mind as you evaluate AS vs any treatment.
Information provided indicates AS is the best choice.
Best Wishes
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1 Reaction@charlesprestridge thanks for the response! I’m 51, my PSA was 3.8. I have a lesion that was found to be benign. I guess my question lies more in the info provided by the decipher test. Are the scores and statistics provided just based on the positive core samples. Or, does it imply or account for other potential cancer not sampled?
Sounds like you are in great shape. Because your father had prostate cancer, you have more than 100% increase in the chance of getting it, One in eight men get it I guess that brings it down to better than 25% chance you will get it.
Rely on getting a PSA test every year. Maybe a biopsy if the PSA starts to rise.
If you do have a rise in PSA and start to be concerned, you could get a PSE test, which can determine whether you have cancer and that you should have a biopsy.
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2 Reactions@mtcoastie I had a Decipher test and scored 0.81. My understanding is that a Decipher score is just based on the analysis of your positive biopsy sample. You are asking about what your healthy cells might indicate and that would come from Genetic (germline) tests which tell you which genes you inherited from your parents like BRCA1/2, ATM, CHEK2, HOXB13, MSH2, etc. The presence of those genes do indicate more propensity towards having cancer in general. With just a 3+3 case and low Decipher score, it looks like you are safe to continue with AS for now.
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2 ReactionsGleason 6 + Decipher .29 = low risk. To put it into perspective, I was Gleason 7 (3 + 4) intermediate risk and candidate for active surveillance until my decipher showed aggressive and high risk .68, that put me into treatment.
If you want peace of mind, you could go for a BRCA2 genetic test, that can be an indicator of familial history that could influence your future - although it's still an emerging science it's better than nothing at all. As Mark says, get those PSA tests every year and don't ever skip one.
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1 Reaction@survivor5280
While BRCA2 Can give you a higher chance of prostate cancer, so can ATM, Lynch syndrome, RB1, PTEN, PT53, CHEK2 and a number of other genetic issues. A genetic test can look for a couple of hundred different genes these days.
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2 ReactionsYou got some good info already, I just want to add since somebody mentioned inherited mutations that you might have none of those and still get very aggressive cancer like my husband did.
IMHO Decipher is the most important predictor BUT for only for THAT particular point of time. As time passes Decipher score can change. With time those "3s" can change into "4"s, and than "5"s : (((.
If you are on AS, make sure you have yearly MRI, and new biopsy every 1 to 2 years with new Decipher score done every time. We were not informed about that by our doctor so 7 years passed before next biopsy was done and that was catastrophic mistake.
Wishing you all the best : ) and super successful AS .
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4 ReactionsI took both Prolaris and Decipher as well. I was told the database to compare samples was larger with the Decipher test.
Here is what AI says about your question:
What Decipher Actually Measures
Decipher analyzes the activity of 22 genes found in prostate cancer cells, focusing on pathways linked to:
Cell proliferation
Cell adhesion and invasion
Immune modulation
Androgen signaling
DNA repair
These gene-expression patterns correlate strongly with how likely a tumor is to spread or recur after treatment. The test does not evaluate normal prostate tissue gene expression.
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3 Reactions@surftohealth88 YES, YES, YES…even the Decipher can change and in so doing, so can your cancer risk. Just be vigilant.
Phil
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2 ReactionsYou can sign up for the PROMISE trial yourself. They test for free, looking at these genes:
APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4, CDKN2A (p14ARF), CDKN2A (p16INK4a), CHEK2, EPCAM,GREM1, MITF, MLH1, MSH2, MSH6, MUTYH, PALB2, PMS2, POLD1, POLE, PTEN, RAD51C, RAD51D, SMAD4, STK11, TP53