← Return to Multiparametric MRI (mpMRI) over diagnosis?


Multiparametric MRI (mpMRI) over diagnosis?

Prostate Cancer | Last Active: Dec 14, 2023 | Replies (32)

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Thanks for the MRI information.

From my research, the BRCA1 gene (and others) are evaluated via “germline genetic testing” from a person’s DNA profile obtained from blood or saliva samples. It is looking for inherited genetic mutations.

“Genomic testing” is done on cancerous tissue taken from the prostate (either biopsy or after RP) in order to provide information about how one’s prostate cancer might behave in the future.

Decipher, Prolaris and Oncotype DX are genomic tests, all of which vary in purpose but are used to evaluate aspects of the genetic makeup of the cancer cells themselves.

For those in my situation (initial diagnosed with low or intermediate risk PCa) it seems genomic testing would be the only one of interest.

For advanced PCa, where the efficacy of various ADT therapies are in question, genetic germline testing may be useful to determine the “best” chemical treatment.

Of course, family members who are curious as to whether they have inherited a genetic propensity toward PCa, because it runs in the family, may also take this particular germline genetic test…but I’m not sure what they would do about a “positive risk” result.

IMHO there are some questions that are best left unanswered. It may be easier to live with this kind of a question, than an undesirable answer….but others may think differently….

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Replies to "Thanks for the MRI information. From my research, the BRCA1 gene (and others) are evaluated via..."

Well good info, that is more than I ever got from Decipher. In about three years on AS I must have spoken to 20 doctors at differing places, and each one I gave the decipher result I got originally. Only one doctor (oncologist) at the start was serious about Decipher. But once he ordered he never said a word on the result to me, and what Decipher sent me was basically nothing with some sort of super general pamphlet. So what you wrote is more than I know because the doctors don't know either is what I guess. I am sure in some cases it matters so one checks, but beyond that not exactly sure about it. There may be hundreds of characteristics tumors have, they can't test all of them some of which they don't even know yet, so in some cases the test may present completely wrong info, or in other cases where you do have the exact characteristics that are in the test well then it makes a true difference. It is still a black box basically for perhaps decades to come for some people who have characteristics not tested for, and with what you get from them it won't be much. Luckily I got insurance to finally pay for my decipher test, but even with really top insurance I had a hard time getting it paid for the pamphlet they gave me.