Low/Intermediate PCa Video Chat, December 8, 2025

Low/Intermediate PCa Video Chat, December 8, 2025

by | Dec 12, 2025 | Cancer Caregivers, Cancer Resources, Low/Intermediate Prostate Cancer, Recorded Groups

Low/Intermediate PCa Video Chat, December 8, 2025

Low/Intermediate PCa Video Chat, December 8, 2025

AnCan is grateful to the following sponsors for making this recording possible: Bayer, Novartis, Johnson and Johnson, Myriad Genetics, Telix, Blue Earth Diagnostics, and Foundation Medicine.

WELCOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.

Join our other free and drop in groups:
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!

Editor’s Pick: Focal therapy sounds great but has higher risk of recurrence. (bj)

Topics Discussed
Importance of getting a second opinion on your biopsy slides by a specialist; don’t rush into a treatment without getting all the information; focal therapy sounds great but has higher risk of recurrence; active surveillance is a viable treatment option—it depends on your risk factors; cryotherapy vs HIFU—effectiveness vs side-effects; fears about erectile dysfunction (ED) and incontinence make focal therapy make it easy to jump on the focal therapy bandwagon; heart disease and hormone therapy (ADT) interactions; balancing open-heart surgery and managing prostate cancer (PCa); symptom management concerns cause me to lean toward IMRT (Intensity-Modulated Radiation Therapy) vs SBRT (Stereotactic Body Radiation Therapy); concerns about ADT side effects.

Chat

AnCan – Stuart sent a chat · 7:56 PM
Dr. Ming Zhou Mount Sinai Health System Department of Pathology, Box 1194 Annenberg Bldg. 15th FL 1468 Madison Ave New York, NY 10029 Email: Ming.zhou@mountsinai.org Telephone: (212)241-8881

AnCan – Stuart sent a chat · 7:56 PM
Dr. Jonathan Epstein – https://advanceduropathology.com/  Tel:516-760-2037    jepstein@imppllc.com

AnCan Bill  sent a chat · 8:17 PM
If you are new, feel free to share your email address here and we will ensure you get our reminders.

AnCan Bill  sent a chat · 8:32 PM
Steve, we were getting a lot of mic noise from you.  We muted you.

Larry (Veteran, Alaskan) sent a chat · 8:33 PM
Do not overlook the potential value of getting a consult from a Medical Oncologist as opposed to Surgical or Radiological.

Martin  Uthe sent a chat · 8:35 PM
Stuart, What is your email? Thank you.

Martin  Uthe sent a chat · 8:36 PM
Larry, Thank you. M

AnCan – rick sent a chat · 8:36 PM
stuart@ancan.org

AnCan – rick sent a chat · 8:40 PM
I would disagrree with Larry at this time. With just a mm or two of 4+3 that we are checking with a 2nd opinion, most Genitourinary medical oncologists would not see you. You will not be able to get an appointment with Maha Hussein or David VanderWeele.   Just seeing a general med onc will only confuse you.

Martin  Uthe sent a chat · 8:41 PM
I am already confused!

Tom O NJ sent a chat · 8:44 PM
Martin confusion is why this group exist… keep coming keep doing research. I am new also and struggling w/ decision making.

Martin  Uthe sent a chat · 8:45 PM
Thank you, Tom.

AnCan Bill  sent a chat · 8:47 PM
Thanks Tom. We are here to help as best we can.

AnCan – Boykin sent a chat · 9:02 PM
Active Surveillance https://ancan.org/event/active-surveillance-prostate-cancer-2/2025-12-10/

Steve sent a chat · 9:10 PM
I was wondering if I should push for a Decipher test now?

Steve sent a chat · 9:11 PM
I tried to get one but its a bit hard from a foriegn country without a US Dr.

AnCan – rick sent a chat · 9:12 PM
Speak with Epstein first and also ask him.  May help but I don’t know enough about Decipher. Dr. John does.

AnCan – rick sent a chat · 9:13 PM
We’re awae that it’s hard to get Decipher outside the country.

Steve sent a chat · 9:13 PM
ok 👍

Steve sent a chat · 9:13 PM
Yes I had Invitae genetic test … all negative.

Steve sent a chat · 9:14 PM
12 genes tested

AnCan – rick sent a chat · 9:14 PM
From Dr. John …. Steve: since there is some ambiguity, why not, if Epstein agrees

AnCan – rick sent a chat · 9:15 PM
Invitae is a germline test – very different to Decipher.

Steve sent a chat · 9:16 PM
Yep understand re: germline … I might have used wrong terminology

Steve sent a chat · 9:16 PM
Thanks Rick

Steve sent a chat · 9:17 PM
Any thoughts on state of the air radiation treatments if I end up there?

AnCan Bill  sent a chat · 9:18 PM
bfranklin@ancan.org

Steve sent a chat · 9:19 PM
My connection dropped so not sure if I missed any texts

Steve sent a chat · 9:19 PM
re: Radiation.

AnCan – rick sent a chat · 9:20 PM
My bad…. didn’t realize the mic was on.

AnCan–John A sent a chat · 9:21 PM
Steve: likely SBRT

Steve sent a chat · 9:21 PM
ok, does that imply MRI Guided?

AnCan–John A sent a chat · 9:23 PM
Steve: probably at a state of the art center.    Maybe CT

Steve sent a chat · 9:23 PM
CT?

AnCan–John A sent a chat · 9:23 PM
Computerized Axial Tomography

Steve sent a chat · 9:24 PM
Got ya, thanks 🙂

Steve sent a chat · 9:25 PM
SBRT with Real-Time Tracking (CyberKnife)?

AnCan–John A sent a chat · 9:26 PM
that’s an example yes

Steve sent a chat · 9:26 PM
MRI-Guided SBRT (MR-Linac: ViewRay MRIdian or Elekta Unity)

AnCan Bill  sent a chat · 9:27 PM
Dr. Sanoj Punnen

Steve sent a chat · 9:27 PM
I will also check with my oncologist who I am seeing for Pet scan in a few hours

AnCan Bill  sent a chat · 9:30 PM
https://sylvester-doctors.umiamihealth.org/

AnCan – rick sent a chat · 9:32 PM
https://sylvester-doctors.umiamihealth.org/

Steve sent a chat · 9:32 PM
I’m considering adding Dr. Kishan at UCLA to my trip.

Steve sent a chat · 9:36 PM
Did you have side effects?

Steve sent a chat · 9:37 PM
I like the idea he is on west coast as its already about 20-25 hrs flight time to get to CA 🙂

AnCan – rick sent a chat · 9:45 PM
dr.john@ancan.org

AnCan – rick sent a chat · 9:46 PM
https://www.uwmedicine.org/bios/effie-andrikopoulou

Steve sent a chat · 9:50 PM
Who was the Dr at UCSF who I should talk to re: Active Surveillance?

AnCan – rick sent a chat · 9:53 PM
UCSF – Peter Carrroll is the expert but winding down. Matt Cooperberg is one. If you can’t get to him, Sam Washington.

Steve sent a chat · 9:54 PM
Thanks Rick 👍

Steve sent a chat · 9:55 PM
Did you have the name and contact of the guy in Malaysia (I think it was you who mentioned him).

AnCan – rick sent a chat · 9:57 PM
Read this metastudy …. https://jamanetwork.com/journals/jamaoncology/article-abstract/2841671?guestAccessKey=d03b0908-90c8-497e-85cd-aebb43ec2a63&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jamaoncology&utm_content=olf-tfl_&utm_term=112025&mc_cid=0fa42784f6&mc_eid=838454d636

Steve sent a chat · 10:01 PM
Thanks so much for all the help guys.  Makes my path alot more focused on best next steps.  Much appreciated 🙏

Steve sent a chat · 10:05 PM
My connection dropped again… back on now

AnCan Bill  sent a chat · 10:05 PM
We are glad you found us. Please keep coming to the group.

Steve sent a chat · 10:06 PM
You guys give us alot more confidence dealing with PC

Steve sent a chat · 10:10 PM
Rick/Stuart do you guys mind sharing your email?

AnCan Bill  sent a chat · 10:11 PM
rd@ancan.org and stuart@ancan.org

AnCan – Stuart sent a chat · 10:11 PM
https://www.uclahealth.org/providers/amar-kishan

AnCan – Stuart sent a chat · 10:12 PM
MR-Linac

Paul N. sent a chat · 10:14 PM
Ask Keeshan about the Prostox test

AnCan Bill  sent a chat · 10:20 PM

Special Presentation: What if You Could Predict the Risk of Radiation Effects – Prostox and Beyond

Carl S. sent a chat · 10:21 PM
Thanks guys, see you next time.

Manuel sent a chat · 10:21 PM
Thanks for a great session!

Steve sent a chat · 10:22 PM
Thanks Guys 🙂

Special Presentation: What if You Could Predict the Risk of Radiation Effects – Prostox and Beyond

by | Dec 11, 2025 | High Risk/Recurrent/Advanced Prostate Cancer, Low/Intermediate Prostate Cancer, Webinars

Special Presentation: What if You Could Predict the Risk of Radiation Effects – Prostox and Beyond

 

 

Featuring Dr. Joanne Weidhaas, developer of the Prostox test. Dr. Weidhaas is a radiation oncologist/ professor at UCLA. Co-discoverer of the biomarker KRAS-variant, she co-founded MiraDx, maker of Prostox, and MiraKind to empower individuals with meaningful health information. Dr. Weidhass’ professional and academic resume includes MSKCC, Yale and Stanford, largely in breast cancer. She also finds time to care for 3 kids and save dogs!

Learn more about Prostox here: https://miradx.com/prostox/

 

 

Low/Intermediate PCa Video Chat, December 8, 2025

Low/Intermediate PCa Video Chat, November 24, 2025

by | Nov 26, 2025 | Cancer Caregivers, Cancer Resources, Low/Intermediate Prostate Cancer, Recorded Groups

Low/Intermediate PCa Video Chat, November 24, 2025

Low/Intermediate PCa Video Chat, November 24, 2025

AnCan is grateful to the following sponsors for making this recording possible: Bayer, Novartis, Johnson and Johnson, Myriad Genetics, Telix, Blue Earth Diagnostics, and Foundation Medicine.

WELCOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.

Join our other free and drop in groups:
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!

Editor’s Pick: Manage “buyer’s remorse” by trusting the decision. (bj)

Topics Discussed
Before treatment (cryotherapy/radiation), get a second pathology opinion (e.g., Dr. Epstein/Dr. Zhou) to confirm Gleason scores; high Decipher scores (e.g., 87) with favorable pathology (Gleason 3+4) may not necessitate leaving Active Surveillance; consult Centers of Excellence. Verify facility accreditation (NCI/NCCN “Centers of Excellence”); manage “buyer’s remorse” by trusting the decision (e.g., MRI-guided SBRT over surgery); weigh recurrence risks of focal versus whole-gland treatment; assess if a PSMA PET scan is necessary for localized intermediate-risk disease; review data on Androgen Deprivation Therapy (ADT) with radiation; consider short-term ADT (6 months) only for multiple intermediate risk factors; consider radiation (SBRT) with whole pelvic coverage over surgery for suspected extra-prostatic disease (lymph nodes) to avoid salvage radiation; use a low Decipher score (e.g., 0.26) to support foregoing ADT with radiation for intermediate-risk cancer.

Chat

AnCan – Stuart sent a chat · 7:58 PM
Dr. Ming Zhou Mount Sinai Health System Department of Pathology, Box 1194 Annenberg Bldg. 15th FL 1468 Madison Ave New York, NY 10029 Email: Ming.zhou@mountsinai.org Telephone: (212)241-8881

AnCan – Stuart sent a chat · 7:59 PM
Dr. Jonathan Epstein – https://advanceduropathology.com/  Tel:516-760-2037    jepstein@imppllc.com

AnCan–John A sent a chat · 8:41 PM
I am grateful to Howie for the term “sixes over sevens”.   I am going to create a new Gleason system using poker terms.

AnCan Bill  sent a chat · 8:42 PM
Well, I wouldn’t want a full house!

AnCan – rick sent a chat · 8:44 PM
McClure at Weill

AnCan – rick sent a chat · 8:46 PM
Vince Laudone and James Eastham at MSKCC

AnCan–John A sent a chat · 8:47 PM
Howie if you want I’ll read your complete Decipher report including GRID report

Mark Erickson sent a chat · 8:57 PM
can you please repeat how to tell if a group is a center of excellence

Larry (Alaska) sent a chat · 8:59 PM
There are 33 NCCN “Centers of Excellence” scattered across the country.

Larry (Alaska) sent a chat · 8:59 PM
https://www.nccn.org/home/member-institutions

AnCan–John A sent a chat · 8:59 PM
The accrediting groups are the NCCN National Comprehensive Cancer Network, or NCI National Cancer Institute.  Go to the website and navigate to Centers of Excellence

AnCan–John A sent a chat · 9:00 PM
thx Larry

AnCan – rick sent a chat · 9:00 PM
877 582 7011

David in Portland, OR sent a chat · 9:01 PM
One picture=1,000 words. This map shows the location of all the NCCN member institutions: https://www.nccn.org/home/member-institutions/

AnCan – rick sent a chat · 9:02 PM
NCI Centers link http://www.cancer.gov/research/nci-role/cancer-centers/find

AnCan Bill  sent a chat · 9:02 PM
Thank you Larry

Mark Erickson sent a chat · 9:02 PM
Thanks all

Larry (Alaska) sent a chat · 9:10 PM
I am a master or buyer’s remorse, seller’s remorse, second guessing and hindsight.  But one makes a decision based on the best information you have and do not hesitate, dither or delay.

Ancan – Boykin sent a chat · 9:13 PM
Recognize that any treatment has consequences. Decide what you can live with. In the end, it’s a personal decision

Jim Stewart Reno, NV sent a chat · 9:22 PM
Have to sign off, Happy Thanksgiving everyone!!!!

Ancan – Boykin sent a chat · 9:23 PM
Happy Thanksgiving Jim!

AnCan Bill  sent a chat · 9:23 PM
Take care Jim.

Bill (VA) sent a chat · 9:30 PM
First meeting I have understood what the focal/nano knife concern is on recurrence.

AnCan – rick sent a chat · 9:34 PM
Optimal Duration of Androgen Deprivation Therapy With Definitive Radiotherapy for Localized Prostate Cancer. https://ancan.us14.list-manage.com/track/click?u=ece3f3da90f82cb974b407396&id=06c8899f70&e=838454d636

AnCan – rick sent a chat · 9:35 PM
JAMA https://jamanetwork.com/journals/jamaoncology/fullarticle/2841671?guestAccessKey=d03b0908-90c8-497e-85cd-aebb43ec2a63&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jamaoncology&utm_content=olf-tfl_&utm_term=112025&mc_cid=0fa42784f6&mc_eid=838454d636

Mark Erickson sent a chat · 9:39 PM
Thanks everyone, Happy Thanksgiving

Ancan – Boykin sent a chat · 9:39 PM
Good Night Mark!

Larry (Alaska) sent a chat · 9:41 PM
Marc, it is a choice (in my mind) between 1) hit it hard and fast with risk of side effects or hit it minimally with s higher risk of recurrence

AnCan–John A sent a chat · 9:41 PM
‘night guys

David in Portland, OR sent a chat · 9:41 PM
Trip Trial compared six months to 30 months of ADT in randomized high risk patients who underwent beam plus brachy. It found no difference in outcomes. The incidence of biochemical recurrence rate at 7 years was 9%: https://www.redjournal.org/article/S0360-3016(23)07843-4/abstract

Bruce Schrimpf sent a chat · 9:56 PM
Great seeing and hearing from all of you!  I plan on being with the high-risk group tomorrow.  I will have an update tomorrow as I have recently returned from Mayo at Rochester.

Ancan – Boykin sent a chat · 9:57 PM
Good night Bruce!

AnCan – Stuart sent a chat · 10:05 PM
https://www.mskcc.org/nomograms/prostate

Tom O NJ sent a chat · 10:11 PM
Happy Thanksgiving All !!

Low/Intermediate PCa Video Chat, December 8, 2025

Low/Intermediate PCa Video Chat, November 10, 2025

by | Nov 21, 2025 | Cancer Caregivers, Cancer Resources, Low/Intermediate Prostate Cancer, Recorded Groups

Low/Intermediate PCa Video Chat, November 10, 2025

Low/Intermediate PCa Video Chat, November 10, 2025

AnCan is grateful to the following sponsors for making this recording possible: Bayer, Novartis, Johnson and Johnson, Myriad Genetics, Telix, Blue Earth Diagnostics, and Foundation Medicine.

WELCOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.

Join our other free and drop in groups:
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!

Editor’s Pick: Cancel rushed surgery and get a second pathology opinion. (bj)

Topics Discussed
Get a second independent opinion on biopsy results before making a treatment decision; validate Gleason 3 + 3 by getting a second opinion on biopsy slides and transfer care to active surveillance friendly medical team; cancel rushed surgery appointment and get a second pathology opinion before choosing a treatment option; schedule post-surgical PSA sooner than 14 weeks and get germline testing given your family history of the BRCA gene; wait for the results of the Decipher genomic test to inform treatment decision; rectal bleeding 9 months post-treatment is likely hemorrhoids rather than radiation proctitis; seek a second opinion to clarify whether lesion is located at prostate base or mid-gland.

Chat

AnCan – Stuart sent a chat · 8:01 PM
Dr. Ming Zhou Mount Sinai Health System Department of Pathology, Box 1194 Annenberg Bldg. 15th FL 1468 Madison Ave New York, NY 10029 Email: Ming.zhou@mountsinai.org Telephone: (212)241-8881

AnCan – Stuart sent a chat · 8:01 PM
Dr. Jonathan Epstein – https://advanceduropathology.com/  Tel:516-760-2037    jepstein@imppllc.com

AnCan – rick sent a chat · 8:07 PM
GoTo  877 852 7011

AnCan – rick sent a chat · 8:15 PM
To sign up for Reminders…. https://ancan.org/contact-us/

AnCan – rick sent a chat · 8:16 PM
We don’t discuss any form of prostate cancer recurrence in this group – please join us in our Recurrence Group

AnCan – rick sent a chat · 8:21 PM
PROMISE genomic test – still accepting new men https://www.prostatecancerpromise.org/?utm_campaign=ANCAN&utm_medium=link&utm_source=Webinar

Tom O NJ sent a chat · 8:48 PM
Thanks Larry …I will bring that up with care team.

AnCan – rick sent a chat · 8:49 PM
Dr.  Penson  https://www.vanderbilthealth.com/doctors/penson-david

AnCan – rick sent a chat · 8:55 PM
Dr. Scarpato https://www.vumc.org/urology/person/kristen-scarpato-md-mph

David in Portland, OR sent a chat · 9:26 PM
Hi Larry, I’ve seen Garzotto give a speech. I believe it was at the OHSU Prostate Conference in 2024. But I’ve never dealt with him one-on-one. So unfortunately I can’t really give you an informed opinion about him. —David

David in Portland, OR sent a chat · 9:31 PM
Larry, Here’s the link to that 2024 OHSU conference. Garzotto’s speech begins 1hr 7min 49sec from the beginning: https://echo360.org/media/a7fc719f-36a0-4f46-acb8-239fcdde5578/public

AnCan – rick sent a chat · 9:45 PM
hemarhoids https://jamanetwork.com/journals/jama/fullarticle/2841054?guestAccessKey=784cce3c-7365-4ddb-8c1e-4af4c653511e&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jama&utm_content=olf-tfl_&utm_term=110625

AnCan – rick sent a chat · 9:51 PM
Dr. Greene   https://uvahealth.com/findadoctor/Kirsten-Greene-1023119013

Low/Intermediate PCa Video Chat, December 8, 2025

Low/Intermediate PCa Video Chat, October 27, 2025

by | Nov 5, 2025 | Cancer Caregivers, Cancer Resources, Low/Intermediate Prostate Cancer, Pancreatic Cancer, Recorded Groups

Low/Intermediate PCa Video Chat, October 27, 2025

Low/Intermediate PCa Video Chat, October 27, 2025

NEW monthly GAY & BISEXUAL MEN’s Prostate Cancer Group starting Tue, Oct 14. Sign up at https://ancan.org/contact-us/

AnCan is grateful to the following sponsors for making this recording possible: Bayer, Novartis, Johnson and Johnson, Myriad Genetics, Telix, Blue Earth Diagnostics, and Foundation Medicine.

WELCOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.

Join our other free and drop in groups:
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!

Editor’s Pick: Treatment recommendations including whole-gland radiation versus active surveillance. (bj)

Topics Discussed
PSA history; biopsy results and the importance of getting a second opinion; imaging for staging & PIRADS scoring; molecular/genetic testing including Polaris molecular predictive tests; treatment recommendations including whole-gland radiation versus active surveillance; PSMA PET scans and their high success rate for detection; various biopsy techniques stressing the importance of getting a MRI before a biopsy; Prostox as a test for predicting urinary issues following treatment; radiation treatments and the potential for urinary and erectile side effects.

Chat Log

AnCan – Stuart sent a chat · 7:45 PM

Dr. Ming Zhou – Mt Sinai Health System
Email: Ming.zhou@mountsinai.org
Phone: 212-241-8881 

Dr. Jonathan Epstein – https://advanceduropathology.com/ 
Email: jepstein@imppllc.com
Phone: 516-760-2037

David Keller Jacksonville, Florida sent a chat · 9:01 PM
Thank you for a good meeting. Need to go. Have a great week.

Jim Stewart Reno, NV sent a chat · 9:15 PM
signing out, good night all!

Henry sent a chat · 9:31 PM
I was also informed to have surgery because of the enlarged prostrate . It changes things, when the prostate is larger than usual.

Mark WV sent a chat · 9:34 PM
Sorry have to go.  good night

Genomic Risk Classifiers: Similar, but Not the Same

Genomic Risk Classifiers: Similar, but Not the Same

by | Oct 28, 2025 | Active Surveillance PCa, Low/Intermediate Prostate Cancer, Prostate Cancer

Genomic Risk Classifiers: Similar, but Not the Same

 

Genomic Risk Classifiers, or GRCs, are lab tests performed on prostate biopsy or surgical tissue to estimate how aggressive your specific cancer may be. A relatively recent addition to prostate cancer care, their use has grown from virtually none to nearly one in five diagnosed cases over the past decade. The three most common tests are Decipher, Prolaris, and Oncotype DX Genomic Prostate Score (GPS).

These tests don’t replace standard measures such as Gleason score, PSA, or imaging results, but they give doctors an additional layer of information to help guide treatment planning. Depending on the result, a GRC may influence key decisions such as whether active surveillance is appropriate, whether to add hormone therapy (ADT) to radiation, or whether to recommend post-surgery radiation.

Although the tests share a similar goal—to clarify how risky a given cancer might be—they analyze different sets of genes and use different scoring systems. There’s currently no universal standard for comparing one test to another, and few long-term studies show whether using them improves survival or quality of life. Still, real-world data offer some interesting insights.

Patients who received Prolaris testing were the most likely to go on to surgery. Those who had Decipher were more likely to receive radiation combined with hormone therapy. Men who had Oncotype DX were the most likely to choose active surveillance. Overall, men who underwent any GRC test were about twice as likely to select active surveillance rather than immediate radical treatment. Among those who did pursue treatment, GRC-tested patients tended to choose radiation more often than surgery.

GRC results are also beginning to shape decisions about focal therapy, an approach that targets only part of the prostate. Studies suggest that men with higher genomic risk scores are less likely to be good candidates for this type of limited treatment because of higher recurrence rates.

Despite their promise, GRCs have limitations. They can be expensive, and insurance coverage is inconsistent. Because each test measures different biological features, results can occasionally conflict or add uncertainty rather than resolve it. And while the tests can better predict the likelihood of progression, they don’t guarantee what will happen in any individual case.

The takeaway:
GRCs are useful tools that can help tailor prostate cancer care more precisely to your situation. But they should be viewed as one piece of the puzzle—complementing, not replacing, established clinical factors and your doctor’s judgment. Used wisely, they can support more confident, individualized treatment choices.

-Stuart Jordan

For more information or questions, please contact stuart@ancan.org.

Cancer Patient Lab: Beyond Single-Gene Mutations: Using Polygenic Risk Scores to Improve Cancer Prevention

Wednesday, October 29th @ Noon Eastern with Giordano Botta, PhD. Polygenic Risk Scores (PRS) are tests familiar to many diagnosed with prostate cancer that allow you to assess the aggressiveness of your disease. Perhaps more familiar as Decipher, Prolaris, or Oncotype Dx, they are becoming standard tools for risk assessment.

Join the event directly here.