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Posted 10/26/2017 3:31 PM (GMT 0)
What is Genimic Test in Prostate Biopsy?
Is it better predictor than the Gleason Scores?
Posted 10/26/2017 5:04 PM (GMT 0)
Smara, they are different. Gleason is an objective current state of cells analysis based on biopsy. Genomic like Decipher extracts genes to predict metastasis. I had Decipher and it showed an intermediate risk. SO my Gleason score and genomic score inform my decision to get treatment. Denis
Posted 10/26/2017 5:22 PM (GMT 0)
Thank you for your reply.
Does the Genomic taste should be done
Before or after seurgery?
Posted 10/26/2017 5:40 PM (GMT 0)
Genomics tests like OncotypeDX, Prolaris, and ConfirmMDX are done from biopsy samples, before surgery or other treatment. Decipher can be done either on biopsy slides, or post-surgery from the samples taken from the removed prostate.
Posted 10/26/2017 5:43 PM (GMT 0)
Genomic tests are very expensive and are only useful in very special situations. Sometimes a man is uncertain whether active surveillance or treatment would be better. In that case, the genomic test is based on biopsy cores. Sometimes a man is uncertain whether to have salvage radiation when there are some signs that the surgery was not successful. In that case, the genomic test is based on tissue from the whole prostate that was surgically removed.

In most cases, the diagnosis based on Gleason score, PSA, and stage gives a clear indication of what to do and no further genomic tests are necessary.
Posted 10/26/2017 6:36 PM (GMT 0)
Thank you whole for your helpful information

Post Edited (Smara) : 10/26/2017 7:45:54 PM (GMT-6)

Posted 10/26/2017 6:38 PM (GMT 0)
Do you know what this test mean in my husband
Pathology report:
ds high molecular weight cytokeratin prostate
Posted 10/26/2017 7:15 PM (GMT 0)
PDA answered that on your other thread - just a special stain they use. Unimportant for you.
Posted 10/26/2017 8:35 PM (GMT 0)
Thank you very much

Post Edited (Smara) : 10/26/2017 3:37:08 PM (GMT-6)

Posted 10/27/2017 4:26 PM (GMT 0)
Allen,
What test is more accurate to
Diagnose aggressive level of the cancer
PSA and Gleason or Genomic Test by Decipher?
Posted 10/27/2017 4:33 PM (GMT 0)
PSA, Gleason, and stage are the gold standard for determining risk. That has not changed with the newest genomic tests available today.
Posted 10/27/2017 4:52 PM (GMT 0)
I agree with Tony. Decipher and other such tests add very little to the predictive accuracy of PSA, Gleason score and stage. It should only be used by those who are "on the fence" in one of the situations I described. I should also mention that it has not been prospectively validated, meaning no one can say with certainty that if it is used by a man to make one of those treatment decisions I described, whether the decision will turn out better than if it had not been used.

Smara, it would help guide answers to your specific situation if you would include a signature with the current diagnostic details. To do that, go to "My Profile>Edit Profile>Signature"
Posted 10/28/2017 1:17 PM (GMT 0)
Please advice:
My husband 64, diagnosed with Prostate Cancer
Few weeks a go.
PSA 7.8, Gleason by Cedar Sinai 4/5
Glesson second opinion by Doctor Epstein 3/4
T1C, Prostate Volume: 55cc, CT and Bone Scan negative.
Decipher Genomic Test: 59 (lowest high).
Because my husband has two different opinions
we are a little confused about the next step.

Post Edited (Smara) : 10/28/2017 7:21:12 AM (GMT-6)

Posted 10/28/2017 3:50 PM (GMT 0)
Smara...here is my opinion of what you should do next:

1) Have Epstein talk to Cedars about the Gleason score. You need to know if you're fighting intermediate risk cancer (Epstein's score) or high risk cancer (Cedars score).

2) I know you've asked for recommendations on other doctors to talk with. Schedule those appointments now and get their advice. You've asked about surgeons and I think you should see one. But I also think you should see 1-2 radiation oncologists. Since you're in Southern California, try to schedule an appointment with Dr King and Dr Demanes.

3) Once you do that, you'll know your husband's risk profile (intermediate or high risk) and have several treatment options to choose from. Hopefully things will be clearer for you at that point.

I know how difficult it is to navigate this. I hope we're helping.
Posted 10/28/2017 4:03 PM (GMT 0)
All of you helping me so much,,
I don't know how I had handle this
situation without you.
Thank you!!!!
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