Decipher Score vs NCCN Markers? Which is to be heeded?

[Properstate]

Especially when they point in the opposite direction. My second Biopsy after a year of PCa and being on alternative therapies was looking promising, so much so that my urologist agreed to put me on Active Surveillance. But after seeing the recent (5/22) Decipher score of 0.86, he has had second thoughts. He had liked the results of my second biopsy (4/22), Johns Hopkins second opinion (5/22) and PSMA PET Scan (5/22) confirmation that the cancer had not spread outside, hence had agreed to put me on AS.

I am seeking second and third opinions (Medical Oncologist, Urologist and HDR Brachy Dr. Albert Chang, UCLA. I am concerned and confused. Any suggestions/guidance/comments? Thanks

[Tall_Allen]

Agree that treatment is more prudent than AS for your situation. Recommend Amar Kishan at UCLA.

No reason to see an MO. An MO has no expertise for your situation.

[Properstate in reply to Tall_Allen]

Thanks Tall AllenI happen to have an appointment with Dr. Albert Chang at ucla to talk about HDR Brachy. I am also seeing Dr Tonya Dorff at COH since she is an MO who specializes in PCa. What i am interested in is finding out how much of a window i have before i need to decide. My hope was and to a large extent still is that i will succeed in my natural treatments in time. God Willing, of course.

[Tall_Allen in reply to Properstate]

Natural treatments are worthless. Recommend Amar Kishan.

[Properstate in reply to Tall_Allen]

With all due respect Tall Allen, I beg to differ with you. The lifestyle and diet changes i made starting 6/15/2021, supplements, juicing (11/day), coffee ememas (3-4/day) , no salt, no oil and no spices, I have made significant progress, hence my Urologist had agreed to put me on AS. It is only when the Decipher score came that he has begun to have doubts. I doubt that very many people would be able to walk in my shoes.Hippocrates said 2500 years ago, Let Food Be Thy Medicine. There is a lot of truth in that. While my situation may not preclude RP or RT, I have known people in worse situation than mine completely cured and recovered. People tend to be down on things that they are not up on, you are too intelligent and wise to do that. I do respect your opinion and your expertise. Thanks

[Tall_Allen in reply to Properstate]

I am very up on that subject, hence my opinion. In fact, I’ve probably read more of the research on that subject than you have. It becomes dangerous when patients think that what ever they read on the Internet qualifies as science and enables them to substitute imaginary cures for proven cures.

[Properstate in reply to Tall_Allen]

Don't want to offend you my man, I do respect the valuable service you provide to the community at large. Thanks

[Tall_Allen in reply to Properstate]

Not offended. But if you want to PM me with your evidence, I’ll be glad to look at it.

[TFU589 in reply to Properstate]

Noticed that you were/are being seen by Dr. Dorff at COH. How did that go? Did you find her advice helpful? Looking at her online, she seems to be dealing with more with advanced prostate cancer, rather than the initial treatment.

[KocoPr]

Well I somewhat agree with TA, but your natural treatments must be done with SOC. It’s good to try to hit this with as many weapons as possible. Natural treatments alone didn’t work for me.

[Murk]

Getting a another opinion with good explanation and their recommended going forward plan is at a minimum comforting.

[Hidden]

I've read quite a few stories about people on AS and then boom, something ugly wakes up and moves fast. Decipher only looks at one slice of your biopsy, the one with the highest percentage of cancer, and it compares the variants and genetic makeup of the cancer within the slice to compare it with thousands of cases from control groups over many years. So I would not take a high risk Decipher lightly.

[Properstate in reply to Hidden]

Thanks. I am not taking this lightly, I have three expert opinions lined up. ( MO, RT and Urologist).

[maley2711]

what was your PSA and Gleason score at diagnosis.....any other negative diagnostics, eg a large number of cancerous cores, something felt during digital exam,etc??

Because you have had no changes for the worse over a period of a year proves nothing re your claim that "natural" treatments will work just as well as proven medical treatments ...we would all like to use such treatments, were their actual scientific studies showing that to be true. Steve Jobs tried the "natural" route..........

You have a urologist who believes your natural treatments are your ticket to cure?

For example, let's assume your biopsy showed Gleason 3+4, and a PSA of 5.5. You implement "natural" means of stopping cancer progress, and you are OK for the next 5 years. Does that mean that the "natural" protocol was responsible for your success? Not at all.....if you use a nomogram such as can be found at the Memorial Sloan website, you would find that the majority of men untreated but with your identical diagnostics escape prostate cancer death for more than 15 years!!! Then again, maybe the majority of those men in the study used "natural" treatments ???