Interpreting DECIPHER test results?

[JPnSD]

I have just been informed my DECIPHER test results are in and they are mailing them to me. I don't have an appointment to review them with my doctor until the 24th. Can anyone suggest a good reference I should read about what these results might look like and questions I should have ready for my meeting? Not sure how versed my Dr. is on DECIPHER...as I had to fight tooth and nail to get it done and approved. She may need the references as well. Thank you.

[tango65]

decipherbio.com/wp-content/...

[Tall_Allen]

Decipher includes info on how to interpret results.

[DJBUNK]

I had a Decipher test conducted last year after my surgery. The report was informative but I still had questions for which I have been unable to find answers.

First, the report gives an estimate of 5yr metastasis but does not define the term. Does it mean what is typically meant by prostate metastasis which is spread to bones, distant lymph nodes, other organs, etc? Or is spread to any node considered metastasis? In my case, the distinction is significant as I had a positive lymph node detected in the pathology. So does my decipher score refer to chances of further spread, or have I already crossed the threshold of metastasis? Or is that estimate meaningless in my case?

The other question relates to the risk category. Does it refer to a patient's risk relative to their previously determined risk category, or relative to the overall patient population?

[tango65 in reply to DJBUNK]

The cancer is considered metastatic when there are cancerous lesions in the lymph nodes outside the pelvis above the bifurcation of the aorta ( cancer is classified as M1a), in the bones anywhere,( cancer is classified as M1b) and in any organ (cancer is classified as M1c).

If your lymph nodes where found only in the pelvis your cancer is not considered metastatic, even when the cancer left the prostate and invaded the pelvic lymph nodes.

I believe the risk is related to the outcome of a population.

academic.oup.com/ndt/articl...

[JRPnSD in reply to tango65]

Thank you for this information. I had microscopic detection of PCA in 1 of 4 lymph nodes during by Prostatectomy....and people continually tell me I am Stage 4, despite vesicles being clear (Stage 3). I look forward to more information for giving me more perspective on where I stand in my journey.. Thank you.

[tango65 in reply to JRPnSD]

Best of luck on this journey!!

[Jmr11820]

I had a DECIPHER as well. The results are fairly cut and dry. First they give you a score... low , intermediate, or high and also your likelihood of metastasis in 5 years and PCSM at 10 years. In my case I had a high score so we acted quickly for radiation rather than wait. I’m not aware of it being helpful in guiding any other treatment options.

[bml123abc in reply to Jmr11820]

Jmr11820 - had the same experience. Received a high score (.92) and decided to get radiation right away. Still one year away from being clean for 5 years but so far so good.

[Jmr11820 in reply to bml123abc]

Great! My .83 DECIPHER had a 33% chance of metastasis at 5 years. PSA prior to RT was . 03.

10 year PCSM 18%. Those numbers are etched into my brain.

Sound familiar?

[bml123abc in reply to Jmr11820]

Yes, mine was 50% chance in 5 years. PSA was 6 before RT. Radiation did some damage but still worth it.

[JRPnSD in reply to bml123abc]

What was your PSA at the time you elected to have radiation?

Thanks

[bml123abc in reply to JRPnSD]

it was undetectable right after surgery and stayed that way so far.

[Jmr11820]

Congratulations on a successful treatment. DECIPHER has caused me a lot of stress. Do you mind sharing your 10 year PC mortality risk, according to DECIPHER?

[JPnSD in reply to Jmr11820]

I have yet to receive it.