Advice on genomic testing: which one, whether it will add anything?

[45RPM]

Hello friends.

Just diagnosed. Intermediate risk stage. I am concerned my PSA (0.7/3yrs) is not indicating true risk. Sister with breast, father melo. PNI in base core sample. 23andME says negative on BCRA1/2 (mpMRI coming. 2nd biopsy opinion coming).

It looks to me like i am trending more towards unfavourable due to some higher risk factors.

So not sure it matters now to get additional genomic tests in terms of treatment decision.

I also find that Polaris, Onco, Decipher show significant discordance between tests, with NCCN risk criteria. medpagetoday.com/meetingcov.... Not sure how to think about this.

Question now: is genomic evaluation potentially helpful given my particulars?

Should i get more than one or all three? Insurance coverage is don't care.

How does 23andME compare given result i have?

Thanks for any help, 45r

[Tall_Allen]

23andME is crap, Color Genome Dx is much better (used by Johns Hopkins). They are germline tests.

The somatic tests (like Decipher or Prolaris) are not useful for you unless you are on the fence about active surveillance. It sounds like you are not, so such tests are a waste of money.

[45RPM in reply to Tall_Allen]

Thank you.

[45RPM in reply to Tall_Allen]

Isn't Decipher only for post RP?

[Tall_Allen in reply to 45RPM]

No. Decipher also has a prostate biopsy test for men on the fence about AS.

[HopingForTheBest1]

There are 2 types of genetic testing. One is a simple inexpensive saliva test; can get from color.com . The other is obtained from a biopsy tissue sample, sent to Foundation Medicine. May be covered by insurance. I first had the color test, then had the Foundation test after my prostate was removed. Both were positive for BRCA2+.

Thanks to these tests I was put on Olaparib, which has been very effective for me by keeping my PSA undetectable.

[45RPM in reply to HopingForTheBest1]

Thank you Best1.

[45RPM]

Thank you Joel will check it out

[tsim]

Or Invitae, Medicare will cover and most insurance should since you've been diagnosed.