Confused by Decipher Test

[drzaius]

Hi all, new here. I signed up to finish reading an article and then saw these posts in an email to me. What a great resource for men with prostate cancer. My PSA went up to 4.4 and then had an MRI which showed a two suspicious lesions (PI-RADS 4 and a PI-RAD 3). Had a biopsy 3 weeks ago and it showed cancer in the prostate. The PI-RAD 3 lesion turned out to be benign. My GS was 3+3, Grade Group 1. I had 3 cores out of 14 that showed cancer in a couple locations that are close to each other. The pathologist also identified PNI in one core. My urologist said that PNI wasn't necessarily the sole decision point so he is recommending AS. I wasn't entirely comfortable with that so ordered a Decipher test for me. I got the results back a few days ago and it put me in the high risk category with a .76. My Father died of prostate cancer at 75 so there's a family connection. I'm 74. Anyway, having a high risk Decipher score has made me rethink my treatment. I'm now thinking of a RP. I'm very healthy with no other issues and take no other medicines. I have a meeting with my urologist to discuss, but having a high Decipher score has significantly changed my perspective, but I wonder if I'm overreacting to this test. Thanks for this forum.

[Tall_Allen]

IMO, you are not over-reacting. PNI and a high Decipher score make you a poor candidate for AS:

prostatecancer.news/2018/03...

I hope you will consider various radiation options, especially SBRT and high dose rate brachytherapy (monotherapy) too.

Where are you located?

[drzaius in reply to Tall_Allen]

I'm in Western North Carolina. Flat Rock, south of Asheville, close to Greenville and Georgia.

Thanks for the reply.

[Tall_Allen in reply to drzaius]

Bridget Koontz at Duke would be a good radiation oncologist to meet with.

[drzaius in reply to Tall_Allen]

thank you very much for the information.

[Adf2529]

I had different readings from Decipher and Oncotype which confused me quite a bit during my period of AS. Four years ago I decided on SBRT, after 3+3 became 3+4. Low volume. Happy with that decision relative to RP and its potential complications.

[drzaius in reply to Adf2529]

Thanks - that information is helpful. Was you Decipher in the high risk category versus your Oncotype or vice-versa?

[Reddmv]

I was on AS with GS 3-4 for several years, then a new biopsy was complimented by a Decipher score of .78 (high risk for metastasis). That pushed me into serious consideration of treatment at age 82. I opted for 5 SBRT radiation sessions and ADH pills for 6 months. Side effects have been manageable. Good luck.

[drzaius in reply to Reddmv]

Thank you for the helpful information. Very much appreciate it.