During my last visit to my Urologist (when we "discussed" the fact that my PSA had dropped dramatically), the Dr recommended a Prolaris Biopsy test be performed.
I got the results back today, and honestly don't know what to think. At first I was bummed. Scoring a 0 on a test is usually not good. Then I looked at the score explanation. The results range down into the negative range (-2.3 to be exact). Dang, I guess I should be even more bummed..... but I'm not!! :)
The chart explanation indicates this:
- The above chart illustrates the AUA Low Rick category, which is composed of patients with varying degrees of cancer aggressiveness. Cancer aggressiveness can be stratified within the category based upon Prolairs Scores, which are indicated below the graph.
So is the chart basically showing different "aggression" levels of low risk cancer? If so, what's the difference between a non-aggressive low risk cancer and an aggressive low risk cancer?
My Dr has reviewed the report, and per the nurse, his suggestion was to read it myself and if I had questions to schedule an appointment. I interpret that as his not being concerned about the results.
I've attached the report below, and here are my thoughts/questions:
- Does my "More Aggressive" rating still fall within a characterization of "Low Risk"? Is my cancer considered 'low risk' but more aggressive than other low risk cancer, or 'more aggressive' (ie not low risk)?
- The scores on the line are based on a median Prolaris Score as of April 10, 2013. Really? This is a "cutting edge" report and they're still using results from 2+ years ago?
- I'm given a 6% Mortality Risk at the 10 year mark, if managed conservatively. What exactly is 'managed conservatively'? Does that mean I've undergone surgery, radiation, etc, or that I've just assumed a more healthy lifestyle and performed active surveillance?
- What exactly do I do with a 6% change that I'll die in 10 years from prostate cancer (if managed conservatively aka no medical treatment)?
- What the heck is a CAPRA score? I've been researching Prostate Cancer for 6 months and this is the first mention I've heard of it. My score is appartenly 5, which equates to 'intermediate risk', which is supposed to, but doesn't, align with my Prolaris assessment of 'low risk'. BTW, you can find your CAPRA score here: https://urology.ucsf.edu/research/cancer/prostate-cancer-risk-assessment-and-the-ucsf-capra-score
At this point, I don't really know whether to feel good or bad about these results. Another challenge I have with this report, is that its Gleason score differs from my 2 original biopsy analyses (one by Johns Hopkins). I'm looking forward to my 3T MP MRI next Tues to determine if I still need to be worried about cancer.
Oh, and the Prolaris report also listed by Gleason Score as 4+2. Both the initial biopsy and 2nd opinion by Johns Hopkins indicated a 3+3. Not exactly sure what to think about that.
Be blessed and thanks for tuning in,
Tom