New prostate cancer diagnosis: Wonder if focal therapy is right for me

@jeffmarc

Also I live near Colorado Springs and my dr. works for CU Health. She is getting CU Health Anschutz clinic located by Denver to do a consult on focal therapy. Our daughter lives near Kansas City and we may also consult with KU Medical Center.

Looks like you are a good candidate for focal therapy. This is by far the best treatment to minimize side effects both immediate and a few years out. Focal therapy may not be an option if the lesion gets worse after a few years of AS. Even if there is a recurrence there is a good chance that AS can be used at that time for the new lesion.

@alanrittel
I still remember when my wife and I went back to the urologist when the biopsy results came back. It's a gut punch.

Today I really have to remind myself that I had cancer and can now say I am cancer-free. Dealing with other age-related issues, but this one is far in the past.

Really appreciate your experience and that you are in remission. Its very encouraging information.

@jim18

Appreciate your review of my situation and your seeing me as a candidate for focal therapy. This is the approach I am hoping will work for me. Now waiting for the drs. to set-up consults. My urology oncologist graduated in 2024 from MD Anderson Fellowship program. They only accept 5 drs a year into this program. So I feel very comfortable with the doctor's recommendations and treatment.

@alanrittel, have you had your consultations with the specialists? Any update?

I have been assigned a navigator. My Urology Oncologist has contacted a radiation oncologist and a Dr who specializes in Focal therapy. She has also sent my cancer biopsy in for genomic testing. Am meeting with the Focal therapy Dr. on May 1 and the radiation Dr in a couple of weeks.

We all have lots to absorb during these times, but just keep in mind, they probably will send out for the decipher genetic test. Take the results lightly. Just my opinion, but if they try to treat you based on the decipher score you might want to doubt them.

Decipher has a handful of genes it tests, 22 only. There could be 100 or 1000 genes involved so I consider decipher, which a number of doctors trust for some reason, to be just about bunk as far as science goes. You test 22 of 1000's possible genes involved in PCa, and proclaim a risk level, that is bunk science. So in my opinion decipher is not the best. It is like predicting who is president after a few % of people have voted, by pollsters outside the voting places. Basically, that is what decipher is.

Yet decipher is immensely popular. PCRI's and popular youtube speaker medical oncologist Mark Scholz kind of doubts decipher in comparing it to other tests, he is one of few professionals that doesn't give it glowing reports. You should not just jump on that genetic bandwagon too much, whatever it reports back to you. The company that owns decipher is making millions of dollars of course in selling it. Hopefully it doesn't give any issues. Just letting you know.

If your lesion is easily reached focal therapy can work.

@bjroc really appreciate your comments. This places an important new perspective on the test. I had no idea until you shared. I will keep this in mind when I meet with the Dr in 6 weeks after which the test will already be complete. Thank you.

@alanrittel
The decipher test is pretty accurate in figuring out whether or not you’re going to have reoccurrences in the next five or 10 years.

Doctors can rely on that information to tell them that somebody would need ADT because their chance of reoccurrence was much higher due to the decipher test. The ADT would extend the amount of time it takes for the cancer to reoccur.

There are other tests that look for the same sort of thing, the Artera AI Test is used for the same reason as the decipher test to find out the chance of reoccurrence.

There are a lot of doctors that depend on the results of these tests to decide what the best treatment would be after initial treatment.