An acquaintance had gleason 6 and a "high risk" result from the Decipher test. His urologist said he could book him in two weeks to remove the prostate. My friend was not keen on that and found someone else who was cool with active surveillance. He's pretty sure he made the right choice.
Gleason-6 here and all healed up from Tesla 3, MRI-targeted biopsy after 13%-17% low volume found in 2 of 12 (counted 18+) cores. We sent some material to lab for genetic, 'background' testing. Will discuss it with doctor in appointment scheduled for the 18th. Not worried about it. Uncle, grandfather, cousin died from prostate & bone cancers. Aunt died from a lymphoma and dad has skin cancers being removed regularly at 88+/- but has no prostate problems. I don't drink alcohol, smoke, chew weird gummies, eat sugar, few carbohydrates and only moderate amount of dairy. I exercise every day. Thank you for the video. Interesting.
You're lucky at 51 i had psa it was 8.7 I had surgery 6; weeks ago to remove I had. 70 ,% Gleason patern 4 at the tumor and 60%. 50%. In two other cores .seing that yours in still in the prostate with the biopsy. The comparison is Quite apparent . It's slow growing in your case
If you go on an active surveillance program there will be MRIs and future biopsies to ensure more lethal varieties aren’t elsewhere in your prostate (missed by the most recent needle biopsy) and to ensure more lethal varieties don’t begin in you prostate. Genetic testing might yield a reason to be even more vigilant or possibly to consider earlier treatment.
The somatic gene test such as Decipher is useful but as Dr. Scholz says Gleason score is what determines treatment. Also my oncologist emphasized the PSA level as an indicator of tumor aggressiveness. So pathology and PSA most important. That’s why it is good to get second opinion on biopsy specimens from urological pathology at a major university medical center.
Timely topic. I am meeting with my Urologist this week to discuss genetic testing. My goal is to use these tests to avoid another biopsy. My MRI showed a PI-RADS3 7mm lesion and I’m on the fence regarding a targeted biopsy. Neither Decipher nor EXoDX is covered by my HMO.
@@mikekratt3110 - yes, sure did. This MRI was done two years after a negative 14 core random biopsy. My PSA had jumped from 2.2 to 5.6 in one year which triggered the random biopsy.
@@TiHerr74 interesting. Almost identical PC diagnosis. I requested the brac genetic test given family history of HGCA. It gives you one more data point in an already complex decision-making process.
Will talk to my urologist about this. I've had a calcification or lesion on prostate for 15 years. According to recent MRI its still confined to the capsule. Will probably have biopsy soon and then I'll know for sure what im dealing with. Im almost 73.
I have a lesion which shows up on my MRI. I also know the doctor who took my first set of biopsies said I had calcification. I was told I have Gleason 6 - so active surveillance for me. I also had a targeted biopsy of the “lesion” - and that result showed no cancer in the lesion. Go figure….
Who is my doctor? The Urologist passed me off to the Radiation Oncologist, but the RO recommended radiation right from the start. My Gleason score is 3+3 (8 cores) and 3+4 (2 cores), with the "4" component being less than 5% of the tumor (so essentially 3+3 overall). So who should I see for 2nd, 3rd opinions?
Can you please comment on PTEN loss found in biopsies? Does this impact what type of treatment or AS in case gleason 6 with PTEN loss? Does Decipher add more info in this case?
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
If u test positive for brca 2, will that make your prostate cancer more aggressive and my oncologist told me if your positive for braca 2 that radiation will not work well, is this true???
I asked you a question sometimes ago but I never got an answer for it so I will ask you again..I am 68 with enlarged prostate my PSA is 2.5 couple of weeks ago my urologist without doing any kinds of tests he scheduled me for the procedure .but I canceled my appointment because I wasn't comfortable with his decision...please help me and tell me what I should do.....thanks so much in advance.......
@@ernesthanks6125I agree with BOTH of you. I'm 54 and had a PSA of 3.24 which is likely attributable to BPH (enlargement) and both myself and the urologist felt I didn't need a biopsy until further surveillance. Six months later there was no "velocity," staying stable at 3.23. Six months later it trended downward to 3.08, then six months later remaining stable at 3.07. Dr. Scholz has mentioned here several times that bigger prostates bring a bigger PSA. Needless to say, a 52 year old guy (2 years ago) with a PSA of 3.24 can raise eyebrows, if not border "alarming." A PSA of 2.5 at 68 years of age is typically considered quite normal.
off topic but I don't understand that on one side they say.. Gleeson 6 will never metastasize then on the other 50% of patients with Gleeson 6 go on to have treatment within 10 years.. Can gleeson 6 change to Gleeson 7.. Anyone. Please help.
Hi, Gleason 6 does not turn into a higher Gleason grade. A higher Gleason is a different tumor altogether. And Gleason 6 does not metastasize. Here is a link where Dr Scholz presents really good information about Gleason 6. Hope it helps: m.th-cam.com/video/nOmK2B5Y9Go/w-d-xo.html
According to Dr. Scholz, Gleason 6 neither metastasizes nor does it turn into a more aggressive cancer. I provide 2 quotes and a link to the video that is the source of the quotes provided here. Can Gleason 6 metastasize? “We now know Gleason 6 is a harmless variant of prostate cancer that never metastasizes. Arguably, maybe shouldn’t be even be called cancer.” Can Gleason 6 change into a more aggressive cancer? “Low grade prostate cancers don’t turn into high grade cancers.” Here is the link to this part of the conversation that is the source the of quotes and provides more details. It starts at the 5 min 34 second mark: m.th-cam.com/video/nOmK2B5Y9Go/w-d-xo.html
Here is my situation .. 51. Original 8.7 psa Gleason 4 +,3. Borderline Johns Hopkins re read my pathology and called it 3+4. Very much ambiguous . I did genetic testing with Invitae theough hospital . I had robotic protestectomy 6 weeks ago.. . NO genetic mutations were found . I had my sperm frozen and my results only showed recessive for. Cistic fibrosis. To make it more complicated . I have a uncle who had pc at almost the same age and also removed . So whete is it coming from . Bad life decisions, diet . Who knows So my genetic are negative for PC i guess
You seem to have a lot of questions and I want to encourage you to manage your case and find answers that make sense to you with your doctor(s). If you have an hour or so, this video is an excellent starting place about how to understand cancer as a metabolic disease not a genetic disease. However, prostate cancer can be different than other cancer forms. This is why most men work with a doctor they trust to help them understand the options. th-cam.com/video/nGo0mtPX-JQ/w-d-xo.html
Answers is a problem ,my oncologist talks to me about 5 mins ,that's it,if I mention u all and utube info they just laugh and leave the room asap,,my doctors are corporate company😮
Thanks for the informative videos.
An acquaintance had gleason 6 and a "high risk" result from the Decipher test. His urologist said he could book him in two weeks to remove the prostate. My friend was not keen on that and found someone else who was cool with active surveillance. He's pretty sure he made the right choice.
Gleason-6 here and all healed up from Tesla 3, MRI-targeted biopsy after 13%-17% low volume found in 2 of 12 (counted 18+) cores. We sent some material to lab for genetic, 'background' testing. Will discuss it with doctor in appointment scheduled for the 18th. Not worried about it. Uncle, grandfather, cousin died from prostate & bone cancers. Aunt died from a lymphoma and dad has skin cancers being removed regularly at 88+/- but has no prostate problems. I don't drink alcohol, smoke, chew weird gummies, eat sugar, few carbohydrates and only moderate amount of dairy. I exercise every day. Thank you for the video. Interesting.
You're lucky at 51 i had psa it was 8.7 I had surgery 6; weeks ago to remove I had. 70 ,% Gleason patern 4 at the tumor and 60%. 50%. In two other cores .seing that yours in still in the prostate with the biopsy. The comparison is Quite apparent . It's slow growing in your case
@@nickstrapko7549 Thank you for responding and I wish you peace and health.
If you go on an active surveillance program there will be MRIs and future biopsies to ensure more lethal varieties aren’t elsewhere in your prostate (missed by the most recent needle biopsy) and to ensure more lethal varieties don’t begin in you prostate. Genetic testing might yield a reason to be even more vigilant or possibly to consider earlier treatment.
The somatic gene test such as Decipher is useful but as Dr. Scholz says Gleason score is what determines treatment. Also my oncologist emphasized the PSA level as an indicator of tumor aggressiveness. So pathology and PSA most important. That’s why it is good to get second opinion on biopsy specimens from urological pathology at a major university medical center.
Thank you, Alex.
Timely topic. I am meeting with my Urologist this week to discuss genetic testing. My goal is to use these tests to avoid another biopsy. My MRI showed a PI-RADS3 7mm lesion and I’m on the fence regarding a targeted biopsy. Neither Decipher nor EXoDX is covered by my HMO.
Did you get an MRI with contrast (gadolinium based)?
@@mikekratt3110 - yes, sure did. This MRI was done two years after a negative 14 core random biopsy. My PSA had jumped from 2.2 to 5.6 in one year which triggered the random biopsy.
@@TiHerr74 interesting. Almost identical PC diagnosis. I requested the brac genetic test given family history of HGCA. It gives you one more data point in an already complex decision-making process.
@@mikekratt3110- thanks Mike. My dad’s father died of PC and my maternal first cousin is fighting metastasized PC now so I am on high alert.
Enlarged prostate BPH ?
Decipher at surgery can give useful info on how aggressively to treat possible recurrence.
Will talk to my urologist about this. I've had a calcification or lesion on prostate for 15 years. According to recent MRI its still confined to the capsule. Will probably have biopsy soon and then I'll know for sure what im dealing with. Im almost 73.
What if they find something? Will they refuse to operate due to your age?
Don't have a biopsy.It'll only spread and you will have to be treated for cancer.
I have a lesion which shows up on my MRI. I also know the doctor who took my first set of biopsies said I had calcification. I was told I have Gleason 6 - so active surveillance for me. I also had a targeted biopsy of the “lesion” - and that result showed no cancer in the lesion. Go figure….
@@thomash681lucky u
how did they find the lesion 15 years ago ?..I though it was poke and hope back then
Thanks! Great information as usual. I was wondering about the potential of the recently approved Episwitch PSE test in the diagnostic scheme.
Very interesting we have come advance in treatment from wend I was treated 2012
Are these the same or similar to a Decipher? Maybe called a decipher code?
Who is my doctor? The Urologist passed me off to the Radiation Oncologist, but the RO recommended radiation right from the start.
My Gleason score is 3+3 (8 cores) and 3+4 (2 cores), with the "4" component being less than 5% of the tumor (so essentially 3+3 overall).
So who should I see for 2nd, 3rd opinions?
Could you speak about reoccurrence its almost 50 percent that doesn't feel like a good cure rate and when it comes back its harder to cure
Can you please comment on PTEN loss found in biopsies? Does this impact what type of treatment or AS in case gleason 6 with PTEN loss? Does Decipher add more info in this case?
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
If u test positive for brca 2, will that make your prostate cancer more aggressive and my oncologist told me if your positive for braca 2 that radiation will not work well, is this true???
I asked you a question sometimes ago but I never got an answer for it so I will ask you again..I am 68 with enlarged prostate my PSA is 2.5 couple of weeks ago my urologist without doing any kinds of tests he scheduled me for the procedure .but I canceled my appointment because I wasn't comfortable with his decision...please help me and tell me what I should do.....thanks so much in advance.......
I'm not a doctor, but i would have made the same decision: cancel the appointment. Then I'd look for a new doctor.
@@ernesthanks6125 thanks
@@ernesthanks6125I agree with BOTH of you. I'm 54 and had a PSA of 3.24 which is likely attributable to BPH (enlargement) and both myself and the urologist felt I didn't need a biopsy until further surveillance. Six months later there was no "velocity," staying stable at 3.23. Six months later it trended downward to 3.08, then six months later remaining stable at 3.07. Dr. Scholz has mentioned here several times that bigger prostates bring a bigger PSA. Needless to say, a 52 year old guy (2 years ago) with a PSA of 3.24 can raise eyebrows, if not border "alarming." A PSA of 2.5 at 68 years of age is typically considered quite normal.
Was the dre result ok
@@nickstrapko7549 Hi I am sorry I don't understand your question...
off topic but I don't understand that on one side they say.. Gleeson 6 will never metastasize then on the other 50% of patients with Gleeson 6 go on to have treatment within 10 years.. Can gleeson 6 change to Gleeson 7.. Anyone. Please help.
Hi,
Gleason 6 does not turn into a higher Gleason grade. A higher Gleason is a different tumor altogether. And Gleason 6 does not metastasize.
Here is a link where Dr Scholz presents really good information about Gleason 6. Hope it helps:
m.th-cam.com/video/nOmK2B5Y9Go/w-d-xo.html
It can change to higher Gleason.
According to Dr. Scholz, Gleason 6 neither metastasizes nor does it turn into a more aggressive cancer. I provide 2 quotes and a link to the video that is the source of the quotes provided here.
Can Gleason 6 metastasize?
“We now know Gleason 6 is a harmless variant of prostate cancer that never metastasizes. Arguably, maybe shouldn’t be even be called cancer.”
Can Gleason 6 change into a more aggressive cancer?
“Low grade prostate cancers don’t turn into high grade cancers.”
Here is the link to this part of the conversation that is the source the of quotes and provides more details. It starts at the 5 min 34 second mark:
m.th-cam.com/video/nOmK2B5Y9Go/w-d-xo.html
@@SeekingWisdom17 It shouldn't as completely different cancer...
@@marinefarmer7494 Look for 'Risk for prostate cancer grade “progression” (from Gleason 6 to Gleason 7 or higher)'
I didnt know that the cancer reoccurrence was so high at 40 percent. And somewhat higher for people who choose radiation .
I like that you give your patients the opportunity to make their own decisions as explained to them what side effects they will have .
Here is my situation .. 51. Original 8.7 psa Gleason 4 +,3. Borderline Johns Hopkins re read my pathology and called it 3+4. Very much ambiguous . I did genetic testing with Invitae theough hospital . I had robotic protestectomy 6 weeks ago.. . NO genetic mutations were found . I had my sperm frozen and my results only showed recessive for. Cistic fibrosis. To make it more complicated . I have a uncle who had pc at almost the same age and also removed . So whete is it coming from . Bad life decisions, diet . Who knows So my genetic are negative for PC i guess
You seem to have a lot of questions and I want to encourage you to manage your case and find answers that make sense to you with your doctor(s). If you have an hour or so, this video is an excellent starting place about how to understand cancer as a metabolic disease not a genetic disease. However, prostate cancer can be different than other cancer forms. This is why most men work with a doctor they trust to help them understand the options. th-cam.com/video/nGo0mtPX-JQ/w-d-xo.html
@@demitasse07 actually not I've been through the gammit and just got my undectable results PSA back
Answers is a problem ,my oncologist talks to me about 5 mins ,that's it,if I mention u all and utube info they just laugh and leave the room asap,,my doctors are corporate company😮
Maybe worth trying to find another oncologist.