Connect
Piecing together your prostate cancer puzzle.
Determining one’s specific prostate cancer prognosis is like assembling a 5000 piece puzzle in which more than half the pieces are missing.
There are many biomarkers and genetic signatures that can help in the identification, characterization and prognostication of one’s specific disease, if even imperfectly.
Its present state, its propensity to grow, its potential to metastasize, its resistance to treatment, its sensitivities to lifestyle modification and even its impact on mental attitude can be partially addressed by systematic and careful study.
Many good discussions in this forum address the biomarkers, but I’d like to address the more “researchy” frontier in this thread…somatic genetics.
If your eyes are glazing over at this point, no worries, you’re excused and can move on to the next thread.😵💫
To kick things off I’ve attached my Decipher GRID “Gene Expression” page and obtained an AI interpretation, which is summarized into one sentence below:
Bottom line:
The reassuring part is that PTEN and pRB are intact, while the main concerns are DNA-repair activity, immune suppression, neuroendocrine-associated signaling, and a strong metabolic shift.
https://medium.com/@mperloe/pten-loss-in-prostate-cancer-the-missing-brake-pedal-50913e904940
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
@topf
Got to give you credit for trying to discuss your GRID report your doctors…not surprised in the least regarding their response…
Veracyte clearly indicates: “GRID data is for research use only and is not intended to guide patient management.”
So…it’s up to you to research the value of your own GRID data…I’m comfortable doing that with my own data, but fully understand if others are not.
To me it’s provides a few more puzzle pieces which tend to nudge in one direction or another regarding the best way forward with my particular case of PCa.
If I wasn’t on the “continental divide” of PCa, regarding AS versus treatment (see my profile); I would probably have much less interest in attempting to understand the detail AND the limitations of the information provided in my GRID report.
@heavyphil
Dr Perloe’s published bio indicates he initially (early 2020) did Tulsa Pro after a 3T mpMRI indicated a PIRADS 0.90 cm lesion and a biopsy indicated some 3+4 and some 4+3 cores.
His PSA dropped from 3.9 to 0.40 three months after Tulsa Pro.
He had germline genetic screening, which was negative and Prolaris testing which was on the border between intermediate and aggressive.
Soon after his Tulsa Pro treatment he signed up
for UCLA’s PSMA Ga68 PET scan clinical trial (also in 2020) which showed extension to the left seminal vesicle.
In retrospect he recommends doing a PSMA PET scan prior to undergoing Tulsa Pro, if one is considering that treatment.
Because his PCa was determined to be already outside the prostate he says he’d now would opt for the Oncotype DX GPS, FoundationOne CDx or Guardant360 CDx, instead of Prolaris.
After receiving his PMSA PET result, he completed 5 Viewray MRIdian SBRT treatments at UCLA.
He was offered either no ADT, or ADT with GNRH-agonist, or GNRH-a plus Zytiga and prednisone.
Telemedicine allowed him to get opinions from 4 different medical oncologists from different centers of excellence.
He ultimately decided to proceed with 6 months of ADT+Zytiga+prednisone with careful follow up.
As far as I know, at 75 years old, he’s doing well managing his locally advanced PCa.
@handera Thanks - that clears up a lot! Best,
Phil