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Is Decipher after RARP overkill?
I'm now 4 weeks post-op for RARP at Mayo Jax. Now I have my 3 month PSA and f/u visit scheduled.
Surgery and Path reports were all good news, no spread, negative margins, 2 lesions (1cm x .5cm x .5cm, .3cm x .3cm x .3cm), along the way I was downgraded from 3+4 to 3+3, was tested and I have no genetic mutations.
From biopsy 4 years ago, the first (and only known lesion at the time) had a biomarker test (not Decipher, but from another company) and it was low risk for spread.
Here's my question. Should I ask doctor to order a Decipher test on my prostate? Yeah, all signs are good (and believe me, I am very grateful for where I am, having a dear brother pass away from metastatic prostate cancer), but seems like having a Decipher on both lesions would be good info to have. Second lesion was not found on my original biopsy 4 years ago and thus was never Decipher tested. Or maybe this is overkill?
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It depends… Each of the (many) biomarker tests (like Decipher, for just one example) looks for a specific genomic marker to help in the diagnosis and treatment of your prostate cancer. Is the biomarker that Decipher tests for one that will help in your diagnosis/treatment post-RP?
Having a brother who passed away from metastatic prostate cancer, have you had a genetic (germline) test to see if you have inherited any gene mutations related to prostate cancer?
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2 ReactionsBecause of the hereditary prostate cancer in your family, I would ask for a decipher score. Your brother, dying of it, greatly increases the chance of you getting it, And while your Gleason score is low Prostate tissue does get out of the prostate and could end up in causing a problem later in your life.
You Should do the decipher on your latest Tissue.
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4 Reactions@brianjarvis Thanks for the response. Yes, I had the Promise/Color test and it showed no genetic mutations for prostate cancer (it showed no genetic mutations for any of their cancer tests).
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1 ReactionYou’ve got nothing to lose, and only more knowledge about what you are potentially dealing with.
That said, a higher than anticipated score might just put you on edge unnecessarily. As long as you do follow up PSA’s, monitor the trend and velocity, nothing changes - not your treatment options or decisions.
Whatever happens from here on in is pretty much standard anyway, so I think you are in a pretty good place.
Phil
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2 Reactions@heavyphil Thanks for your advice. This morning I sent a message to doctor asking to have Decipher ordered, guess there's no reason for them to say 'no'.