Decipher Score and ADT

[Scvol]

An update on my journey.

Targeted Biospy 9/24/24, 9 samples.

7/10 (60% pattern 4, grade group 3). Carcinoma present 2 of 3 cores approximately 10% of the tissue.

Thought about getting second opinion on biopsy but didn’t. Now I’m rethinking the second opinion of biopsy. My decipher score is 0.37. Low risk. It seems odd that my decipher score is low, clinical stage T1c and my biopsy being unfavorable intermediate risk. Should I get a second opinion on the biopsy?

That leads me to think hard about ADT. I’m not in favor of ADT given success rate of radiation alone.

[pjd55d]

in my opinion - and experience - a second opinion has great value

often a second opinion reinforces and reassures the care you are receiving

[Tall_Allen]

Short-term ADT improves the results of radiation for UIR PCa.

prostatecancer.news/2020/09...

[Scvol in reply to Tall_Allen]

TA,

It’s more about the results of my Decipher score and the marginal difference in ADT vs not. My Decipher indicates 3% with ADT and 4% non ADT. My thought was get a second opinion on my biopsy to confirm report. Why do ADT if the difference is close ? Would like to send my results to you and possibly discuss. Thanks. Ralph

[LowT in reply to Scvol]

Yes. Get second opinion.

[LowT in reply to LowT]

Biopsy more important than Decipher.

[Tall_Allen in reply to Scvol]

4-6 months of ADT is pretty minimal, but maybe unneeded with brachy boost therapy. Maybe a second opinion from a brachy boost therapy expert is in order.

[Scvol in reply to Tall_Allen]

Thanks much TA.

[MrGreenJeans]

I'm 4+3 (all details in bio) and had a decipher of .55. My RO at MSK was somewhat on the fence about adding ADT to my SBRT, basically left it up to me, and I went with 6 months of Orgovyx. Been on it for about 2 months and only issue I've had is with the hot flashes at night screwing with my sleep. I have not felt tired, depressed, etc. Been trying to exercise as much as possible. One thing I'd highly recommend is to lose a few pounds before starting ADT. I've always had no issue controlling, losing weight, etc. and it's been a challenge once I started the Orgovyx.

[Scvol in reply to MrGreenJeans]

My Dr is likely to recommend Lupron, two months prior and four after SBRT. Appreciate your input.

[MrGreenJeans]

I'd push for Orgovyx if you can. MSK was ready to give me Lupron until I asked for Orgovyx. Had to wait 3 weeks for insurance approval and was able to sign up for their discount program for $10/month (otherwise it would have been $100). Everything that I've read and confirmed with my RO yesterday is that testosterone recovery is much faster once you finish Orgovyx but can last many months after Lupron.

[Scvol in reply to MrGreenJeans]

Many thanks!

[contrktr]

Dr. Sartor at Mayo…they have a lot of new treatments out based on new trials.

He is world renowned, he used to be at Tulane, very accessible, can tele visit, and extremely easy to talk to.

You can have your slides sent to any of these institutions by just contacting them, they will arrange to get your slides.

My decipher was low risk and I wound up with an aggressive cancer, so I don’t hold much stock in that test.

Biopsy I had slides sent to MD Andersons and John Hopkins, as well as Texas Cancer, Tulane, Ochsner and Mayo, with each one grading a bit different….7 different hospitals total counting one I wouldn’t recommend.

Also get the Tempus XF test to check for mutations.

[MrGreenJeans]

Interesting about your Decipher results, wonder how common that is. Having all of those second and third opinions on slides would have been pretty expensive for me. I only had a second opinion at MSK where I'm currently undergoing treatment, and the results matched what my initial values were.