A Decipher Shower

[farmanerd]

My 0.94 Decipher score has given me a shower to sail through before getting back into the sun: second reading of my surgical pathology at my nearby NCCN member institute.

*****

Original pathology:

Prostate, da Vinci radical prostatectomy:

- Adenocarcinoma, bilateral, Gleason score 4+3=7 (Grade Group 3), with focal extraprostatic invasion, focal

invasion of the bladder neck musculature, and foci of involvement of the inked apical margin (see description).

Seminal vesicles, right and left, da Vinci radical prostatectomy:

- No evidence of malignancy.

Soft tissue, "periprostatic fat", excision:

- Venous thrombosis, focal.

- No evidence of malignancy.

*****

Updated pathology:

Prostate, radical prostatectomy (B1-B39):

- Adenocarcinoma, Gleason score 8 (4+4) with minor high-grade pattern 5 (1%) and focal intraductal carcinoma, prognostic group 4, comprising 15% of the gland, with focal extraprostatic extension and invasion of bladder neck, present at distal apical margin (4 mm, pattern 4) and bladder neck margin (1 mm, cauterized), see comment.

-Bilateral seminal vesicles with no histopathologic abnormality.

See comment.

Soft tissue, periprostatic fat, excision (A1-A3):

- No evidence of malignancy.

*****

Haven't received the whole new report yet, just saw this addendum placed in my original pathology report. I started 6 month ADT a little over a week ago with radiation to the prostatic fossa planned to start in a month or two. I don't currently see any benefit to widening the radiation field or increasing length of ADT with two post-RARP PSA's of <0.1. My anastomosis is going to get blasted.

[Hidden]

No evidence of malignancy . Fantastic .

[Blackpatch]

Look, i know that high Decipher is a bummer - but when you dig through tonnes (and I do mean tonnes) of papers you’ll see that they routinely register scores in the high 0.9’s in even low risk situations. I’m not saying your situation is LOW risk, but just not to eat too much in the one number.

The most positive thing in your pathology report from my perspective is the all clear on the seminal vesicles - those little puppies turn up as major culprits in nearly every risk analysis i’ve Looked at in the last two years - dodge SVI and you’ve dodged a very major bullet!!

Stuart