Guidance in Decisions from Artera

It looks like you are trying to make a decision on active surveillance vs. treatment. The Artera AI test provides 3 percentages: Absolute 10-year risk of 1) Distance Metastasis and 2) Prostate Cancer specific death; it also provides a comparative risk of Metastasis within the group. You should get all 3 numbers to help you make a decision. It is a new test so not much experience. They also use PSA, clinical stage, and age in the prediction. Your age (probability of dying) will lower the percentages reported. Other numbers you should have are percent of 4 in the 4+3 cores; how much of those cores were cancerous; how many other cores were cancerous (3+4 or 3+3). PSA test results and how fast they are rising. At 80 the longevity of male relatives and general health should also be taken in consideration. Treatment is not fun and the side effects can be worse.

The problem is you have a 4+3 and that really does call for treatment not active surveillance. Radiation could easily resolve the problem and wouldn’t give you too many side effects. My brother at 77 was a 4+3 had five sessions of SBRT radiation and is doing fine now that he’s 80.

I guess the big problem is your prostate is so big that the radiation guys don’t want to handle it. I know a radiation RO at Mayo said during his talk recently, that he doesn’t like Treating a prostrate larger than about 75 cc.

I know one guy that has large cribriform And is a 3+4. He refuses to have anything done yet. He has had the ArteraAI Test done and The decipher test and another one, And they all show low chance of reoccurrence. He has spoken to at least five or six well known doctors and has decided that he’s not going to do anything yet. He has a PhD in engineering and is very picky about everything he hears.

You are a 4+3, however, and that is a lot more aggressive.

Have they talked about putting you on ADT to try to reduce the size of your prostate so they can treat it more easily? Do you have problems like BPH that has caused an enlarged prostate, And can be treated with antibiotics.

You could get a decipher test to see if it concurs with the ArteraAI test.

@tommyg
If it were me, I would get the Decipher test which uses your biopsy material to check on aggressiveness. I would get a telehealth second opinion from a center of excellence. I also might choose a Prostox test to see my sensitivity to radiation especially if I wanted to do 5 higher doses vs more lower doses. Again, for me, if I was 80, I would be discussing the race against the clock side effects with my doctor.

I'm past the point of initial treatment decisions but if I had to start over, I'm fairly certain AI would not be making those decisions for me, nor would it have any influence on my thought process. It's just not there yet.

@bens1 Decipher was .45
I've conferred with Memorial Sloan Kettering (2nd opinion). My prostate is so big ROs say I'm not suitable for radiation therapies. I'm considering aquablation or hi-fu to reduce my prostate size so I have more options.