Decided on nerve sparing surgery

I was watching a u tube video with renowned urologist Dr sholtz and he uses decipher test as a tie breaker for AS,
and that the test is overly pessimistic and secondary to modern advanced imaging and the test frequently categorizes patients into higher risk brackets than their true clinical reality dictates and points out that decipher risk prognostication are built on decades old historical data.

In some cases you can have 3+3 and a high decipher score also.

@ezupcic

Pathology looks ate the shape, size and distribution of cells and Decipher measures genetic markers which are actually molecules (can not be seen under the microscope).

In some cases you can have 3+3 and a high decipher score also.

@ginger38314
And 3+3 is not even considered cancer or should be called cancer by many today. It shows Decipher is one more measurement of several, MRI, PET, Gleason, PSE, , PSA,,ExoDx for you and your Doctor to discuss. It is often not one, but a totality of all to help render your decision. I know of two who have had Decipher but fall short in other aggressiveness measurement’s. Do you just run off with the most aggressive treatment because you had a high decipher and nothing else pointing that direction. It is for you and your Doctor to decide. Not everyone with a high decipher has ended up needing the most aggressive treatment, and yet you will hear , OMG you have a high decipher you must do this. Remember your treatment is a decision of a totality of what all the diagnostic tests and procedures and it may be the deciding factor or it just may be another factor.

I was watching a u tube video with renowned urologist Dr sholtz and he uses decipher test as a tie breaker for AS,
and that the test is overly pessimistic and secondary to modern advanced imaging and the test frequently categorizes patients into higher risk brackets than their true clinical reality dictates and points out that decipher risk prognostication are built on decades old historical data.

@ginger38314 Don’t know if I trust him on most topics.
Look at almost any video he does, and it’s always the rosy side of whatever the main subject may be.
How can Decipher be based on ‘old data’? As Surf mentioned, it’s based on your RNA - seems pretty current to me.
Also, if you want to see ‘old’ go no further than this favorable vs unfavorable nonsense…what a ridiculous concept on which to base treatment.
Tell me I’m a Gleason 3+4 and I KNOW it’s better than a 4+3….BUT, as we have repeatedly seen, a small volume of Gleason 3+4 can be highly aggressive and metastasize from the get go…is that favorable? 🤔. I guess Dr Scholtz would say it is, right? But Decipher would tell a different story.
Call me pessimistic, but when I was told I was a Gleason 4+3 Unfavorable, I immediately considered myself Gleason 8. There was no Decipher at the time so I opted for surgery with SRT as a backup since G8 has higher rates of recurrence.
Thank goodness I did…Best,
Phil

@ginger38314 Don’t know if I trust him on most topics.
Look at almost any video he does, and it’s always the rosy side of whatever the main subject may be.
How can Decipher be based on ‘old data’? As Surf mentioned, it’s based on your RNA - seems pretty current to me.
Also, if you want to see ‘old’ go no further than this favorable vs unfavorable nonsense…what a ridiculous concept on which to base treatment.
Tell me I’m a Gleason 3+4 and I KNOW it’s better than a 4+3….BUT, as we have repeatedly seen, a small volume of Gleason 3+4 can be highly aggressive and metastasize from the get go…is that favorable? 🤔. I guess Dr Scholtz would say it is, right? But Decipher would tell a different story.
Call me pessimistic, but when I was told I was a Gleason 4+3 Unfavorable, I immediately considered myself Gleason 8. There was no Decipher at the time so I opted for surgery with SRT as a backup since G8 has higher rates of recurrence.
Thank goodness I did…Best,
Phil

In some cases you can have 3+3 and a high decipher score also.