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Decipher Results are in... ADT recommendations?

Posted by maverick75 @maverick75, Jun 6, 2023

Decipher test results just in and unfortunately I'm in the high-risk range for metastasis at .69. Awaiting discussion with RO. Anxious to find out if there are any PC brothers out there who are further down a similar path. I'm 70, good health, PSA never above 3.4, single 1 cm lesion right side, 4+3 (intermediate, unfavorable), left side clean, all tests point to localized disease. Prepping to start 5 session SBRTs at Mayo Jax next month. RO told me earlier he'd use Decipher tests results to guide potential multi-modal therapy recommendations but already said if high risk, would likely recommend RT be followed by Orgovyx for 4-6 months. Anyone else in a similar situation further down this path?

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service1010 | @service1010 | Nov 14 8:04pm
In reply to @cesar52 "I had a DECIPHER done on 9-12-2018. My risk was even higher than yours: 1.0. 5-year..." + (show)
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I had a DECIPHER done on 9-12-2018. My risk was even higher than yours: 1.0. 5-year risk of metastasis was 52.6%. Still survival at 10-year was 70%. Remember there are still numbers. I got ADT and Radiation Therapy. I have a very aggressive cancer. I would suggest that you go for radiation for sure. Get ready for side-effects. ALL cancer treatment cause them. I still wear a pad 5 years removed from surgery and radiation. But I feel good. And I can see my kids and wife, friends and family. Wish you the best.

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@cesar52 Your report in 2023 is similar to what DH just got. How are you doing 2 years later?

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heavyphil | @heavyphil | Nov 15 7:34am
In reply to @maverick75 "Thanks, I've read these studies. The meta-analysis study that I think you're referring did not delineate..." + (show)
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Thanks, I've read these studies. The meta-analysis study that I think you're referring did not delineate FIR versus UIR ("...The original intention of our meta-analysis study was to further divide intermediate-risk PC into FIR and UIR. However, after analyzing the included studies, we found that few studies conducted this subgroup analysis.). For the UIF group like me, especially with the confirmation of a Decipher analysis, I believe there's a stronger case for consideration for at least a short course of ADT. There is at least retrospective data which suggest that ADT benefits patients with unfavorable, but not favorable, intermediate-risk cancer, others suggest there is no added value with ADT for men over 70 in conjunction with RT. Bottom line, it's pretty squishy for a 70 yr old with UIR. I may roll the dice and do a short course (4 months) of ADT...

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@maverick75 4-6 months of Orgovyx ‘aint gonna kill ya’ my urologist told me…he was right and even the SE’s weren’t as bad as promised.
The ADT gave me peace of mind that the cancer was bring fought on two fronts(at least for me anyway); and if all it turns out to be is an expensive placebo, then it was still worth it.
Phil

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maverick75 | @maverick75 | Nov 15 8:49am
In reply to @service1010 "@cesar52 Your report in 2023 is similar to what DH just got. How are you doing..." + (show)
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@cesar52 Your report in 2023 is similar to what DH just got. How are you doing 2 years later?

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@service1010 I'm doing well. PSA results still showing NIL.

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ellen45 | @ellen45 | Nov 15 12:56pm

My hubby is 80. P-rads 5, Grade 5 prostate cancer, .99 decipher and Gleason of 9 cancer broke through capsule and was in seminal vesicles and nerve bundles. That was 2 years ago. He had 3 mos. Of raditation followed by 2 years of Abiraterone + prednisone and Lupron Depot every 3 months. The decipher test was very important in determining treatment. However, there was another test we didn’t ever hear about called AR-V7 that determines that the Abiraterone/Lupron will be effective. This test said it would not be effective, but our doctors still thought it was best to go the Abi/Lupron route. So we got 2 more years of life out of the treatment. No everything is stopped so we shall see what happens. Take every day as a gift. Your results look much better than my hubby! All of us on this site are with you!!!

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service1010 | @service1010 | Nov 15 2:39pm
In reply to @service1010 "@cesar52 Your report in 2023 is similar to what DH just got. How are you doing..." + (show)
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@cesar52 Your report in 2023 is similar to what DH just got. How are you doing 2 years later?

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@service1010 You give me hope. Thank you

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