A downgrade from G8 (4+4) to G7 (4+3) is both common and good, as were the findings of no positive nodes among those examined, and no seminal vesicle invasion. However the 75% pattern 4 is still fairly large and the EPE is an adverse feature that figures into the prognostication of the likelihood of a rise in PSA and the possible need for further treatment.
The first PSA test is usually done with the standard PSA test for men with prostates. So if it comes back as <0.1, that's a very good beginning. If possible, I would try to have his subsequent tests done with an ultrasensitive PSA test (one that yields 2 or 3 digits after the decimal place). These are much better tests for men with one or more adverse findings after surgery: (1) one's PSA nadir (which usually occurs in the first 6 months) can be a statistical prognosticator of BCR risk; (2) these test afford more lead time before treatment when tracking a rise; (3) they allow fine-tuning for deciding how early one wants to have early salvage treatment.
Regarding a genomic test such as Decipher, you can certainly wait a bit. However, assuming his PSA is first PSA is <0.1, there is something to be said for genomic testing sooner and keeping it your back pocket rather than waiting until it becomes necessary. It could be years (and hopefully never) before your husband's PSA rises to a level where salvage treatment needs to be discussed, and, as you correctly pointed out, knowing one's risk for mets within 5 years (low, average, or high) can play a role in deciding how early to start early salvage therapy. The Decipher test could certain wait until the PSA starts to rise, but (1) even though U.S. institutions keep tissue 10 years (or longer in some states), specimens can be misplaced or get lost, and (2) knowing the met risk up front may be psychologically preferable for some folks. Knowing this risk can perhaps also guide you as to how long you want to keep testing PSA at 3-month intervals.
Just some thoughts -- we're all different. As my dad used to say, That's why they make chocolate and vanilla. I certainly hope you can both put prostate cancer in the rear mirror now!
Post Edited (DjinTonic) : 5/7/2021 7:31:57 PM (GMT-6)