I'm not a doctor. My urologist is considered top-notch. (In fact, his mentor told me yesterday, that my doctor is "a genius," "5-star," one of the top two urologists around.)
I am a Gleason 6, I've had six biopsies over 13 years and 2 MRIs. The cancer was seen only once in 2010/2011 in a transrectal biopsy and an MRI. And it never was seen again.
I was an early adopter--more than 20 years ago--of DNA technology to research my roots.
I switched to my doctor about eight years ago BECAUSE he is a genetics exert. In addition to his mD, he is a PhD in molecular biology.
He has never ordered an OFFICIAL molecular test for me.
I have taken one--as part of a study. I never got a call back from the study. My doctor said I should assume they found nothing.
We're living in an imperfect world, especially in PROSTATE Cancerland. Loads of conflict in scores and opinions. It's frustrating and may be anxiety provoking or downright depressing.
We run into contradictions. Like a high genomic or somatic testing score and yet nothing is seen in the biopsy. Or we take multiple genomic genomic tests and they conflict. Some guys may find themselves being urged to have surgery or radiation based on a molecuar test. even though they keep coming up with nothing on a biopsy.
Personally, I would stay away from molecular testing if I have low-risk Gleason 6. Why add confusion to the fire? Yeah, it's great to get a lot of data. But should we get data we don't need in a certain point. Some experts suggest that the "sweet spot" for these tests is high-volume Gleason 6 and low-volume 3+4. But ask your own doctors, and get a second opinion if you need one from a genomics expert on even to be tested.
I quote UMich's Dr. Todd Morgan at the end of today's article. Please weigh his advice.
Jamie, again I am a fellow patient and can't give advice other than to say maybe you need to speak to a genomics expert. You're taking a glass half empty approach, Maybe the tea leaves you should emphasize ought to be the biopsy results, which my genomics-expert doctor calls one of the best tools in his toolbox.
Thank you for all your research and helpful articles. This article regarding decipher was eye opening and scary at the same time. I am part of the unfortunate few that a local uro did sign us up for decipher. So now I’m stuck with a high decipher.8 but with a very low risk cancer. 3+3 with one core 5%. With two negative follow-up biopsies. But maybe I should be putting more weight on decipher?
Jamie, it is so interesting to read your response to Howard's article. I tested 4+4 on one tumor, and 3+4 on two additional 15% tumors. Yet, my Decipher score is .21. My (third!) urologist was a little puzzled but did agree to my request for active surveillance as long as got a PSA four times per year and annual MRIs / Micro Ultra Sound exams. I would love to read Howard's (and Dr. Spratt's) analysis on your last question.
What a fantastic article, Howard. Here is my favorite takeaway: “The scores [from competing tests] are pretty darn highly correlated from one test to the next. There are differences, but the scores are pretty well correlated. And if you get two tests, and one's higher and the other lower, you would have no idea what to do with the information.” Decipher tested the test of the three geometric studies.
I'm not a doctor. My urologist is considered top-notch. (In fact, his mentor told me yesterday, that my doctor is "a genius," "5-star," one of the top two urologists around.)
I am a Gleason 6, I've had six biopsies over 13 years and 2 MRIs. The cancer was seen only once in 2010/2011 in a transrectal biopsy and an MRI. And it never was seen again.
I was an early adopter--more than 20 years ago--of DNA technology to research my roots.
I switched to my doctor about eight years ago BECAUSE he is a genetics exert. In addition to his mD, he is a PhD in molecular biology.
He has never ordered an OFFICIAL molecular test for me.
I have taken one--as part of a study. I never got a call back from the study. My doctor said I should assume they found nothing.
We're living in an imperfect world, especially in PROSTATE Cancerland. Loads of conflict in scores and opinions. It's frustrating and may be anxiety provoking or downright depressing.
We run into contradictions. Like a high genomic or somatic testing score and yet nothing is seen in the biopsy. Or we take multiple genomic genomic tests and they conflict. Some guys may find themselves being urged to have surgery or radiation based on a molecuar test. even though they keep coming up with nothing on a biopsy.
Personally, I would stay away from molecular testing if I have low-risk Gleason 6. Why add confusion to the fire? Yeah, it's great to get a lot of data. But should we get data we don't need in a certain point. Some experts suggest that the "sweet spot" for these tests is high-volume Gleason 6 and low-volume 3+4. But ask your own doctors, and get a second opinion if you need one from a genomics expert on even to be tested.
I quote UMich's Dr. Todd Morgan at the end of today's article. Please weigh his advice.
Jamie, again I am a fellow patient and can't give advice other than to say maybe you need to speak to a genomics expert. You're taking a glass half empty approach, Maybe the tea leaves you should emphasize ought to be the biopsy results, which my genomics-expert doctor calls one of the best tools in his toolbox.
Thank you for all your research and helpful articles. This article regarding decipher was eye opening and scary at the same time. I am part of the unfortunate few that a local uro did sign us up for decipher. So now I’m stuck with a high decipher.8 but with a very low risk cancer. 3+3 with one core 5%. With two negative follow-up biopsies. But maybe I should be putting more weight on decipher?
Jamie, Could you send me your Decipher test. I just want to learn more about the test.
I'm at howard.wolinsky@gmail.com
Jamie, it is so interesting to read your response to Howard's article. I tested 4+4 on one tumor, and 3+4 on two additional 15% tumors. Yet, my Decipher score is .21. My (third!) urologist was a little puzzled but did agree to my request for active surveillance as long as got a PSA four times per year and annual MRIs / Micro Ultra Sound exams. I would love to read Howard's (and Dr. Spratt's) analysis on your last question.
What a fantastic article, Howard. Here is my favorite takeaway: “The scores [from competing tests] are pretty darn highly correlated from one test to the next. There are differences, but the scores are pretty well correlated. And if you get two tests, and one's higher and the other lower, you would have no idea what to do with the information.” Decipher tested the test of the three geometric studies.