Recent diagnosis

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Afrnd2all
Afrnd2all Member Posts: 3 Member
edited February 2022 in Prostate Cancer #1


Statement: Good Morning. I am 66 Y.O. male diagnosed 10/21. PSA 4.67. Biopsy revealed 1 positive sample out of 12. Gleason Score 7 (3+4) 6% involvment of sample. Stage T1C. At this point my Radiology Dr. had suggested Active Surveillance. We were still waiting on one final result. Upon receiving the results of a decipher score 0f .62 they suggested we do SBRT radiation. I have not found much info. about Decipher scores here. Has anyone on here had them done? If so, Has it changed your treatment options? Thanks in advance.


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Thank you!

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  • Old Salt
    Old Salt Member Posts: 1,345 Member
    #2
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    A biopsy samples a very small amount of the prostate. Therefore, it would be good to have results from an MRI and/or PET scan to see what is going on in that wonderful (?) organ of yours.

  • Afrnd2all
    Afrnd2all Member Posts: 3 Member
    #3
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    Thanks Old Salt. I’ve had two MRI’s. One in Oct. And a second just two weeks ago. Tumor is 1.5cm. Confined to prostate only. Has not spread outside of prostate sac. I should have written ? Differently. I was looking for more info on personal experience with Decipher scores.

  • VascodaGama
    VascodaGama Member Posts: 3,662 Member
    edited February 2022 #4
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    Hi,

    The decipher test does not alter a treatment option but it influences the judgment of the doctor providing a clinical stage. In fact this test is just a predictive tool estimating on how cancer will behave in the future. The score (in percentage) refers to the risks of spreading and it has been established based on the results collected from the stories of some patients including cohorts from clinical trials.

    The low risk group gets a score from 0 to 0.45, the intermediate group goes from 0.45 to 0.60 and above that are the high risk cases.

    Yours at 0.62 predicts possibilities in future spreading which may justify to stop AS. The recommendation for the RT option derives also from the possibility in future recurrence if the initial choice has been RP. However, these predictions are not a concrete base to certify the future status of a patient as no one case is comparable.

    In your shoes I would continue with AS, following the traditional regimen of tests and exams (including extra biopsy) imposed by the AS program, and would be attentive to any continuous increase of the PSA or shortening of the double time (PSA-dt).

    I wonder the AS standards practiced at the clinic attending you.

    Welcome to the board.

    Bestwishes

    VGama

  • centralPA
    centralPA Member Posts: 270 Member
    edited February 2022 #5
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    You definitely look to be smack-dab in the middle of the grey area of AS versus treat. Favorable intermediate risk (FIR).

    From one perspective, it seems like it makes your decision hard to make. Which is best? you can google on "active surveillance for favorable intermediate risk" and see the discussions ongoing.

    From the other perspective, you can't really make a bad choice since you are in the grey area where either choice is reasonable. So I recommend go with your gut. Just know you don't have to decide right this second. If there is information to be gathered that can help refine your probability distribution, be patient and collect it.

    Regarding the genomics, I am in a similar boat to you (FIR) and had the Polaris test, which put me in their green zone. My thinking is it is not an on-off thing, it is a shading of the probabilities thing, to be considered in total with everything else. The genomics is still science in progress. Ultimately, all of this stuff gets fused in your noggin and results in a gut reaction.

    Best of luck!

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