2 Decipher Tests, Which one should be used for treatment??

Appears that the pre surgical decipher was to guide to active surveillance, surgery or Radiation.
The post decipher used, it appears on how to treat after the procedure has been done.
I can see how it would be confusing.
I would not wait for the Dr. Appointment...message the Dr and Team and ask might be best.

Wishing you both the best.

Ray

Well, these tests are not perfect, that’s for sure. The important thing is the rise and velocity in his PSA tests.
If the PSA is rising rapidly over a 3 month or 6 month interval, the cancer is more aggressive than one which might be staying the same for perhaps 2 tests and then moving up 0.01 on the next.
So don’t focus on Decipher since it’s only a suggestion…PSA is the real indicator. Best,
Phil

I would wanna know what the factors were in the prostate cancer case.

How high was the Gleason score? What was the PSA at diagnosis?

Were any of these things found in the biopsy intraductal, ductal, large cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive.

Those can help as much as a decipher score if aggressive Problems were found.

@jeffmarc Gleason score was 3+4, PSA at dianosis was 14.4. Yes there was some sort of spread, think it was ECE. found in one node at time of prostate removal. 15 month doubling time, which is slow. On Orgyvox now and did 25 rounds of radiation. Finished in Feb.

@heavyphil Took 15 months for doubling time.

@ray092271 Thank you. I put a message on the portal but feel I won't get the answer until our next appt.

Good luck. Be persistent its ok.
Dr!'s want thier co-pay right away so why shouldn't you want an answer right away?

@jnlracer18 So to get this straight in my head: he had surgery, rise in PSA, and then SRT with ADT which he is still on.
So has the PSA risen while on ADT??
If not, don’t worry; SRT would have been the same no matter the Decipher test, and no matter the velocity.
The only thing that would change is the duration of ADT, which, of late is 6-12 months.
His doubling time is not really a flashing red signal.
Phil

Decipher is not done on the entire sample/specimen but only on the most aggressive core/section. Also, at pathology they do not anslyze every single cell in the prostate. Somehow they may have missed the most aggressive area at pathology. Not sure if this is common. He did not get any ADT before the surgery, right?

@jnlracer18
The real important thing is what is your PSA now. You had it treated, It may stay undetectable for the rest of your life. With a low Gleason score, you have a real good chance that it won’t come back.

Normally a 3+4 would have six months of ADT but because you had ECE, Or at least some spread outside the prostate, They would want to do it longer.

I didn’t go back and read the top of this message so I mentioned getting a decipher test. You have had two of them, but according to AI the one that is most important is the higher score if it was from the prostate biopsy. Yours had opposite results. Is it possible they didn’t send the most aggressive part of the biopsy to the decipher company? Here’s some more information about it.

Receiving discordant Decipher test results for prostate cancer recurrence can be confusing, but it is not uncommon. In cases where two different Decipher tests provide conflicting risk scores (e.g., one low/intermediate and one high), the result from the specimen with the most significant or advanced disease—usually the surgical pathology (radical prostatectomy) rather than a needle biopsy—is generally prioritized by clinicians.