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Decipher score

Posted by ginger38314 @ginger38314, 5 days ago

Well my decipher score came in at .86 so with 2 3+4 cores 10% and 30%component of 4, I see Urology surgeon on 8/28 and will opt for surgery, also epe was 20-40 % and said unlikely seminal vessels were 0-20% and lymph nodes 0-20%. Just was hoping for a low score and no such luck.

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ginger38314 | @ginger38314 | 4 days ago
In reply to @zmarkv "@ginger38314 Is your Oncologist a top tier GU Medical Oncologist, not a regular Medical Oncologist? It’s..." + (show)
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@ginger38314 Is your Oncologist a top tier GU Medical Oncologist, not a regular Medical Oncologist? It’s a lesson that I wished I had learned about earlier.

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I believe so the cancer center I'm going to is ohsu and is #1 in Oregon for
cancer treatment.

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thmssllvn | @thmssllvn | 4 days ago

DECIPHER, ARTERRA (AI review of biopsy), AI review of MRI, e.g.,(deepviewimaging.com), blood tests (PSE), and the PSMA PET CT scan flesh out a mosaic of indicators. It seems they recalibrate the classic Gleason RISKs of metastasis for gland-contained disease. LOW or HIGH scores may have less predictive power to recommend action steps in their context. More detailed information can only be helpful in the decision process.

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mjp0512 | @mjp0512 | 4 days ago

To quote @notpetecrowarmstrong

"Your big picture is excellent and there are many men here who would trade seats with you in a heartbeat..."

I'm one of those men. Hang in there and don't let worry rent space in your head. Life goes on. It's just a little different at times. Best wishes.

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ireland1964 | @ireland1964 | 4 days ago
In reply to @ginger38314 "Thanks same to you. I will keep you informed after the test." + (show)
Profile picture for ginger38314 @ginger38314

Thanks same to you. I will keep you informed after the test.

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@ginger38314 I’m sure our Pet scans will open a new learning curve and hopefully you can get yours before meeting with the surgeon.
Does your decipher now mean ADT either way you decide?

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dgd1953 | @dgd1953 | 4 days ago

My situation was similar to yours (2 cores of 30% 3+4, Decipher 0.84, clean PET/PSMA scan). I was 69 at the time. I opted for 39 VMAT sessions with no ADT. Interestingly it was my RO who nixed the ADT. Now three years have passed and I am in remission with no serious side effects (sexual function was an issue prior to my cancer diagnosis and remains an issue today). I am grateful to be free of that small amount of a nasty cancer. I wish you all the best.

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ireland1964 | @ireland1964 | 4 days ago
In reply to @notpetecrowarmstrong "@ginger38314 My situation was nearly identical to yours: exact same .86 Decipher score and a low-volume..." + (show)
Profile picture for notpetecrowarmstrong @notpetecrowarmstrong

@ginger38314

My situation was nearly identical to yours: exact same .86 Decipher score and a low-volume 3+4 cancer in two cores. I opted for surgery largely because of my age (51 at the time): two radiation oncologists at two COEs both said they strongly recommended surgery over radiation given my youth and general health. I'm 14 months out from surgery and PSA remains undetectable, and functional recovery has been good, so I'm happy with my decision.

Of note, my post-surgical pathology found both large cribriform architecture and focal intraductal. Both of these are markers of aggressive cancer, and neither had been seen on needle biopsy. But the tumor volume and grading was the same as on biopsy, my margins were negative, there was no detectable escape from the prostate gland, and 5 lymph nodes were clear. Still, the high Decipher score and the cribriform/IDC-P had me uneasy.

You write "Everything thing seemed favorable with Gleason score and only a.8cm lesion
so very bummed out at this point". I felt similarly, so let me share something one doctor said to help me contextualize it: he said that "you had a very small amount of a very nasty cancer, but all indications are it was contained and your surgery was successful."

Everything other than your Decipher *is* favorable, and you're looking at favorable odds for successful treatment. Your cancer may be genomically aggressive but you seem to have caught it early enough where it's quite likely curable. Be grateful and put your trust in your care team to guide you through the process.

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@notpetecrowarmstrong In the same group & waiting on the Pet but also leaning towards surgery primarily due to similar stories like yours about what is found post path.
Did those results then require any RT or ADT?

Glad to hear things are working well. Did you have any type of NS-Ralp done?

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ginger38314 | @ginger38314 | 4 days ago
In reply to @mjp0512 "To quote @notpetecrowarmstrong "Your big picture is excellent and there are many men here who would..." + (show)
Profile picture for mjp0512 @mjp0512

To quote @notpetecrowarmstrong

"Your big picture is excellent and there are many men here who would trade seats with you in a heartbeat..."

I'm one of those men. Hang in there and don't let worry rent space in your head. Life goes on. It's just a little different at times. Best wishes.

Jump to this post

Thanks for the encouragement hopefully my pet scan is clean and can proceed
with treatment.

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ginger38314 | @ginger38314 | 4 days ago
In reply to @ireland1964 "@ginger38314 I’m sure our Pet scans will open a new learning curve and hopefully you can..." + (show)
Profile picture for ireland1964 @ireland1964

@ginger38314 I’m sure our Pet scans will open a new learning curve and hopefully you can get yours before meeting with the surgeon.
Does your decipher now mean ADT either way you decide?

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If the pet scan shows no spread and is confined than removal without adt
but now with radiation would add 6 months adt for 5 treatments sbrt which
I'm strongly considering. My urologist put in for pet scan yesterday and
put urgent on it so hopefully they'll expedite the process.

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ginger38314 | @ginger38314 | 4 days ago
In reply to @dgd1953 "My situation was similar to yours (2 cores of 30% 3+4, Decipher 0.84, clean PET/PSMA scan)...." + (show)
Profile picture for dgd1953 @dgd1953

My situation was similar to yours (2 cores of 30% 3+4, Decipher 0.84, clean PET/PSMA scan). I was 69 at the time. I opted for 39 VMAT sessions with no ADT. Interestingly it was my RO who nixed the ADT. Now three years have passed and I am in remission with no serious side effects (sexual function was an issue prior to my cancer diagnosis and remains an issue today). I am grateful to be free of that small amount of a nasty cancer. I wish you all the best.

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I just turned 69 hopefully my pet scan is clean I'm leaning towards sbrt 5
Treatments + 6 months adt but with orgovyx instead of Luprone. Hopefully
have the same positive outcome as you.

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notpetecrowarmstrong | @notpetecrowarmstrong | 4 days ago
In reply to @ireland1964 "@notpetecrowarmstrong In the same group & waiting on the Pet but also leaning towards surgery primarily..." + (show)
Profile picture for ireland1964 @ireland1964

@notpetecrowarmstrong In the same group & waiting on the Pet but also leaning towards surgery primarily due to similar stories like yours about what is found post path.
Did those results then require any RT or ADT?

Glad to hear things are working well. Did you have any type of NS-Ralp done?

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@ireland1964

"In the same group & waiting on the Pet but also leaning towards surgery primarily due to similar stories like yours about what is found post path. Did those results then require any RT or ADT?"

No, I had RALP without ADT or any supplemental treatment. ADT is not presently indicated alongside RALP for men in GG2 without confirmation of spread, even if there's a high Decipher score. It is more typically indicated in conjunction with RT because it has been shown to improve the effectiveness of RT in many circumstances.

"Did you have any type of NS-Ralp done?"

Yes, I had bilateral nerve sparing and chose a surgeon who's done more than 1000 procedures. I felt that the skill of the surgeon plays such a big role that I was willing to travel in order to have the surgeon I wanted. Thankfully my insurance covered it all.

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