Has anyone with a high risk decipher stayed on Active Surveillance

See if you can get a second opinion with a medical oncologist who specializes in PCa. Urologist can be dismissive about Decipher and other similar tests.

Does "GC2 70/30" mean GG2 (3+4) with 30% pattern 4?

Your age and PSA levels are also relevant, as are any aggressive markers like cribriform pattern or IDC-P. But personally I would not consider AS with 30% pattern 4 and a 0.95 Decipher. Taken together, that's a near guarantee that your cancer will progress (and possibly rapidly as far as prostate cancer is concerned).

You should request your Decipher GRID report. Among other details, it gives a probability of upgrade and I'd hazard a guess that you'd be looking at a high likelihood that your biopsy under-graded your cancer and you'd be upgraded after surgery.

If you're seriously considering AS, then at minimum I'd recommend having your biopsy re-read by another institution like Johns Hopkins, to try to confirm the grading.

Thanks for the responses. Age 70, PSAD .21 PSA 5.7. PIRAD 5. I plan on a second opinion. And will do radiation when the time comes, which is probably right around the corner.

Yes 30% grade 4.

@mkanteck

I was 20 years younger than you at diagnosis (last year) and also had 3+4 with 30% pattern 4. I decided on surgery and we were planning for it about 4 months out (to give me a summer break beforehand) when I received my 0.86 Decipher score. Multiple doctors' advice was to schedule the surgery asap.

My 0.86 put me in the 95th percentile for genomic aggressiveness. Your 0.95 probably puts you in the top 1-2%, and not in a good way. If not treated, your cancer is going to progress and will eventually metastasize, it's a question of when, not if.

You potentially have a window to cure it right now, but the longer you wait, the greater the risk that you'll miss that window and will be playing whack-a-mole with the metastasized cancer for the remainder of your life.

It's your decision to make, and your care team are your best resource, but any doctor advising AS in your situation should be aggressively questioned as to why. Go for that second read of your biopsy, find an oncologist at a COE to speak with, and push for a PSMA PET scan to search for any signs of spread. Then make the decision you feel is best for yourself. Best of luck.

I was diagnosed with 2 out of 12 cores with 3+4 taken from a .8cm lesion one was 30% involvement with a 10%component of 4 the other 30% involvement with a 30% component of 4 psa density. 14 currently waiting for decipher test results would like to do 5 sbrt treatments as the oncologist suggests but if the test comes in high will do nerve sparing surgical removal because there are more treatment options in case of reoccurance.

Personally There's no way I would do AS with a 3+4, even if the decipher test came in low, a friend of mine had a low decipher score and low percentage of 4 from 3+4 and the following year his psa jumped 2 points and the subsequent biopsy was 4+3, just not worth the risk. 3+3 would be the only way I would do AS.