Do they normally do a pelvic lymph node dissection with surgery?

I've found that it depends on the surgeon, but this is something you should raise with them. I had the same Decipher and Gleason scores and pushed for at least some PLN dissection given the elevated risk for spread implied by the Decipher. They took out 5, which is a fairly low number. Thankfully all were negative.

Was your pet scan negative too and how are you doing now.

When I met with last week he didn't bring it up, but I emailed him today
and next week he'll probably get back to me, but I'd rather be safe than
sorry.

So you had no adverse pathology and what were your numbers that the decipher testing company gave you like 5 year metastasis and 10 metastasis and so on. Thanks

My Doctor felt regardless it was necessary as he was in there, when else would you get them.

When I met with him he didn't bring that up but I emailed him about that
issue I'd rather be safe than sorry.

I had a radical prostatectomy 12/22. They took 35 lymph nodes of which 6 were hot. Statistically if the surgeon had disected only five i may have been called clear. On the other hand i recently read a cautionary article about negative effects on the lymphatic system by removing too many lymph nodes in a given location.

How are you doing now and how extensive was your cancer.

@billfarm wrote "On the other hand i recently read a cautionary article about negative effects on the lymphatic system by removing too many lymph nodes in a given location."

That was a part of my surgeon's calculus. Despite having a high Decipher score, I had a relatively low-% favorable intermediate cancer, a PSA under 7, and a PSMA PET that showed no visible signs of spread, so he targeted only 5 LNs in the area his team considered most likely for regional spread.

I asked whether the Decipher score warranted more aggressive sampling but he said it was his opinion that the downsides of dissecting more started to outweigh the clinical value given the rest of my profile.

A higher grade or greater % cancer, or any number of other factors, could have argued for a larger number of LNs to be sampled, of course.

@ginger38314 I'm now 15 months out and PSA is where we want it to be, so I'm taking it 3 months at a time.

I'm glad you're doing good that's reassuring, sounds like you' were In
similar situation that I'm in now, hopefully I have the same positive
outcome.