I received my Decipher GRID report and have only started to digest the information. My Post-Op Radiation response is “61”. My predictive ADT response was “17” and my 5 year risk metastasis is “39”. My Decipher score was .73
I have an appointment with RO next week to discuss options for adjuvant or salvage radiation.
You'll want to read info on this page as you look at the detailed part of your GRID:
The more important questions are
- What has your uPSA been since prostatectomy?
- Were there any adverse pathological features?
I think there is some value in Decipher for men who had no adverse pathology and very slowly rising uPSA. Or some adverse pathology, but stable uPSA.
Gleason 4+4. SVI, EPE, IDC, PIN,
uPSA 60 days post op. .006
Thanks - I see the issue - your very low PSA and your IDC-P (with GS 8) are telling different stories. I don't know if Decipher can account for IDC-P (good question to ask Genome Dx). Did you ever have high PSA before treatment, or is low PSA characteristic for your type of PCa?
Pre-op PSA 12.7. No other relevant PSA’s at my annual physical at the VA. I accepted the no PSA opinion that was prevalent at the VA
It is unlikely then that you have a "low PSA" kind of PCa. Hopefully they got it all.
A rhetorical question as I don’t see myself taking this path. People have asked “what if you don’t have any post-op treatment and let it take its course?”
I was looking at their new GRID report. They used to provide a 10-year risk of metastases in addition to the 5-year, but they removed that. I guess that the scores are all within the gray zone, predicting average response to ADT and to radiation? But I suspect you are an outlier for their report because of your IDC-P.
My ADT response at 17% appears to be low. Am I to conclude that I would likely have failed adjuvant ADT?
No - Call them at Genome Dx - I don't think they took your IDC-P into account. A recent analysis suggests that with your GS 8 and your pT3b, 2-3 years of adjuvant ADT may be beneficial with your SRT, if you decide to have it:
europeanurology.com/article...
SRT? Would the same apply to ART?
Read the article I cited and/or this one:
pcnrv.blogspot.com/2016/08/...
According to their study, even if PSA is below 0.5, you still have 2 of the 3 risk factors they identify. RTOG 9601showed no benefit to adjuvant ADT if PSA was below 0.7, but it didn't include men with pT3b and had too few GS 8s to draw actionable conclusions. None of these studies looked at IDC-P at all - I think that is the determinative risk factor.
Great information! Thank you so much!
These links have some information which could apply to you situation:
I keep saying this, that "Tall_Allen really knows his shit".
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 03/22/2019 1:55 PM DST
Decipher and me
Advice on obtaining Decipher pre-SRT
Seeking advice on course of action after Decipher Report
