Genome biopsy test is deciding factor for definitive treatment but

[Bythetree]

Hello brothers.I am 74 and have no other disease,etc but prostate cancer,and active , and exercise everyd ay. Genome biopsy test- says LoHiRisk,Cilnical data put me in low to intermediate risk.3+4=7 grade 2,pss was 4.7, now down to 3.0,after a 7 month PB diet change.Urologist says,hormone theraphy med and a RT or RP,is the way to go for my case. But can that slide pathology be used for any farther genetic info on alternative theraphy i.,e.personalized genectic T-Cell building,PD-L1 inhibitors,or T cell inhancers,etc? The genome test gene expression says they are causing mutant cell growth,and the genetist says gene expression can be changed.I hoping it is already changing for the better,but can another biopsy tell if so.i am trying to decide if I should just go ahead with definitive treatment.thanks

[Bythetree]

Thank you, Is a MO a Medical Oncologist. For info sake 'I had Epstein at J.Hopkins, confirmed the first biopsy's Gleason 7. Thanks again

[Tall_Allen]

Active surveillance may be appropriate if there was low volume GS3+4 and the percent pattern 4 was<10%

"Genome biopsy test- says LoHiRisk" Doesn't make sense - which was it?

[maley2711 in reply to Tall_Allen]

low end of high risk???

[Bythetree in reply to maley2711]

Yeap -low end of high risk

[maley2711 in reply to Bythetree]

So , just past the intermediate risk level? Seeems you probably would worry too much if decide to defer treatment? These are horrible decisions we face!!!

I'm Gleason 4+5 in one core and 3+3 in one other......of 18 samples total, which is approx 180 mm total length, they found < 1mm of 4+5 .....thus less tha 1/2 mm of the really bad stuff Gleason 5.

Something I read on Decipher website...just 5% chance genomic test would reclassify me as low risk......and probably not even enuf tissue to do the test. I was OK about having radiation and crossing my fiingers re side effects...but adding ADT has really spooked me.....so immediately life-changing it seems at my almost 74 years?

[Bythetree in reply to maley2711]

Looks like we are in similar situations with (plus)hormone treatment and age. I heard that a lot of exercise ,weight lifting,walking ,etc helps ease the side effects of hormone treatment.i guess I 'll start pushing myself now before starting treatment, as much as I can anyway. Thanks

[Bythetree in reply to Tall_Allen]

Tall_Allen Tumor Quantitation- percentage of total prostatic tissue involved by tumor:6%Histologic Grade :grade group2(Gleason 3+4=7 Percentage ofpattern4 in highest Gleason score cancer:40%

[Tall_Allen in reply to Bythetree]

40% is too high. So, it is high risk according to Decipher as well. You need treatment.

[Bythetree in reply to Bythetree]

It would of help if my doctor would have explained things in more details, and said that number is the crucial factor. He said ,I probably needed RP or RT and Hormone treatment, but we can order a Decipher Genomic test to make sure.It came back High Risk.I took a PSMA PET scan 7weeks ago and it indicated no spread .So I guess I have to do something soon.

Thanks for the info

[Fightinghard]

My vote - you need to start treatment. With RT and 2 years of hormones, you still could have a chance to kill the beast. Find a comprehensive cancer treatment center within driving distance. They will have RT and MO experts to help guide you

[Bythetree in reply to Fightinghard]

FightingHard thank you much