After a positive biopsy, your doctor will review your biopsy report and use the Gleason score and other clinical parameters such as PSA to determine next steps in treatment. Your doctor’s treatment recommendation will be partly based on the risk or likelihood of disease progression and the aggressiveness of your cancer.

After surgery, your doctor will also use the Gleason score and other clinical parameters to determine the risk or likelihood that the cancer will recur. The likelihood of prostate cancer recurrence after prostatectomy depends on the extent and aggressiveness of the cancer.

The Role of PSA

PSA is routinely used as an indicator of disease progression or recurrence in men after biopsy and prostate surgery. Doctors determine that some men with rising PSAs may not necessarily need immediate treatment after biopsy, while other men may. For men who do undergo surgery, at least two thirds will never experience PSA rise (or biochemical recurrence) indicating their disease is under control, while one third will experience PSA rise, and may have disease that is more aggressive.

Relying on PSA and PSA changes over time doesn’t always reliably allow physicians to understand what is happening with your cancer.

The Role of Genomic Testing

Genomic tests evaluate the activity of certain genes in your tumor to tell you something about how your prostate cancer may behave and develop over time.

A genomic test like Decipher Biopsy, for example, can give you and your doctor an independent assessment of whether you can delay or forego therapy, or if you do need treatment, such as radiation or surgery. A genomic test like Decipher Post-Op, can help you and your doctor determine if you need treatment after surgery to minimize the likelihood of your cancer from returning.

Knowing this valuable genomic information provided by Decipher Biopsy and Decipher Post-Op tests based on the genomics of your cancer, can help you and your doctor make important decisions about your care.

Click here to learn more about the role of genomic testing in prostate cancer.

  1. Pound, C.R., et al., Natural history of progression after PSA elevation following radical prostatectomy. JAMA, 1999. 281(17): p. 1591-7.
  2. Zelefsky, M.J., et al., Metastasis after radical prostatectomy or external beam radiotherapy for patients with clinically localized prostate cancer: a comparison of clinical cohorts adjusted for case mix. J Clin Oncol, 2010. 28(9): p. 1508-13.