Does a Gleason Score of 8 mean they cannot operate

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Picco
Regular Member


Date Joined Jun 2012
Total Posts : 42
   Posted 6/16/2012 7:44 PM (GMT -7)   
Peter and I went to the GP on Saturday and we told him what the urologist had said.  He was not happy about hearing how we had received no information from him, just told to have radiation.  He also disagreed regarding Peter not being fit and healthy enough for any surgery just because of his stroke.  He has told us to go to see the radiologist oncologist on 28 June with the scan results and see what she says.  If it has not spread outside the gland, then he has asked us to request her to see a Professor there who is the head of the oncology department.  Has any one had a GS8 and it still be contained in the prostate, or is that reading a foregone conclusion to it already have escaped? cry

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3279
   Posted 6/16/2012 7:55 PM (GMT -7)   
Has any one had a GS8 and it still be contained in the prostate, or is that reading a foregone conclusion to it already have escaped?
 
G8 can be contained but there are other considerations like disease volume, DRE results and PSA.  So without more information it's impossible to even guess if the cancer is contained in this particular case.
 
ed
 
 
age: 57
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl
6/8/11 PSA .2, T = 540 ng/dl
8/19/11 PSA .3, T = 487 ng/dl
10/5/11 PSA .2, T = 530 ng/dl
3/1/12 PSA .3

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24335
   Posted 6/16/2012 8:03 PM (GMT -7)   
Yes, a Gleason 8 could be fully contained, and could be eradicated with surgery as a primary treatment, but more info and data is needed here. The Gleason number alone, is not sufficient information to state an opinion upon.

Best wishes,

David in SC
Age: 59, 56 dx, PSA: 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, original catheters 63 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/10 .04, 8/10 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8, 12/11 14.0, 4/12 37.0
Other: Spent total of 1 ½ years on 21 catheters, had Ileal Conduit Surgery 9/10
Member of Prostate Cancer & Chronic Pain HW Communities

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2375
   Posted 6/16/2012 8:27 PM (GMT -7)   
I had G8 PC and had DaVinci surgery back if Feb 2009. My PSA prior to surgery was under 3.8. My biopsy showed 2 out of twelve cores with cancer. I did have EPE but negative margins. So far after over 3 years my PSA has remained <.01.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
DaVinci surgery 2/9/09 Gleason 4+4 EPE,
Margins, SV, clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
PSA tests every 3 months undetectable
PSA at 32 months: .005
Latest PSA on 1/25/12 .094 (ouch)
retested2/21/2012 <.01
retested on 4/3/12 <.01 (38 months)

KJ63
Regular Member


Date Joined Apr 2012
Total Posts : 286
   Posted 6/16/2012 9:42 PM (GMT -7)   
Hi Picco.

My husband is a GS10. He was dx 12/09 by DRE...his PSA was 1.7. All 12 cores positive GS10. Fortunately, the cancer was confined to the prostate only. The decision was made by his doctors removal of his prostate was too dangerous. He had weeks of radiation, and later on brachytherapy (seed placement).

He is on HT and other medications and is doing very well. PSA is .01. SE of the meds and HT are the biggest problem.

Picco...we keep our fingers crossed and do not give up hope. It is what it is....you must deal with the hand dealt. You have already shown remarkable strength and courage. Keep up the fight.

Good luck and my very best wishes to you and your husband.
Kathy
Husband...age 69..70/July
Diagnosed PC 12/09 DRE, PSA unreliable (1.7)
Lpros-poorly differentiated Prostatic Adenocarcinoma GS 5+5=10 (#1,2,5,6,9,10)
Rpros-same as above GS 5+5=10 (#3,4,8,11)
Radiation and Brachytherapy HT ED continues

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 476
   Posted 6/16/2012 10:23 PM (GMT -7)   
Picco, I was a G9, with organ contained disease. Negative margins, neg lymph, and neg sem ves. My psa was ~ 3.00 at the time of surgery. Most oncologists consider G8,9, & 10 to be essentially the same for treatment protocols.

PCa spreads three ways; 1. Via lymph system, 2. Via blood stream (systemic), and 3. By growth outside the capsule. if your guy is in otherwise good physical condition, then surgery should be an option....but that's a call by a good uro. Sounds like you need one.

When my uro gave me the results of my biopsy, he spent over 1 1/2 hours with my wife and I. He answered a ton of questions, and was very reassuring. He did my surgery 7 weeks later, and I was continent within a couple of weeks.

You and your guy are going to be okay. This is absolutely the best forum for guidance and answers to your questions. Particularly from John T, Tony, Fairwind, Goodlife, Sonny and 142. These guys really have a good handle on the best PCa treatments for a given pathology. At least consider their suggestions as you educate yourself. There are many others here who are also knowledgeable.

God Bless

K
Age 57 at Dx
5/09 PSA 2.26
6/10 PSA 3.07 FPSA 18% DRE +
Biopsy, 7 of 18+, >60%, 4+5=9
7/21/2010 - RRP
Nodes & Ves neg
tumor contained, still 4+5=9
pni ext.
9/3/10 - 0.04 99% continent
10/14/10, 0.04, and lupron #1, 99.9% continent
Total ED, implant on 12/15/10
2/11 - 0.04, HT #2, 6/11 - 0.04, HT #3, 10/11 - 0.04, Ht #4
4/12 - 0.04, Ht # last, next psa - 10/12

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5953
   Posted 6/17/2012 6:31 AM (GMT -7)   
The short answer to your G8 question is no. But as others have mentioned, there are a lot of other factors to consider, which I will not pain you by repeating.
 
I was  G8 (4+4 - the composition of the number is very important) at biopsy, and did have surgery.
Moderator - Prostate Cancer
(Not a medical professional)

DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Water Guy
Veteran Member


Date Joined Jul 2011
Total Posts : 2404
   Posted 6/17/2012 6:45 AM (GMT -7)   
It is very difficult with any Gleason grade of PC to know if it is still contained in the prostate without a surgery pathology. Bone scans can determine if there are any mets in the bones but can still be inconclusive. Even a G6 grade can escape the capsule and spread, but it is much rarer than with higher grades. A pathology report after surgery is the best way to determine if the tumor has spread and what the Gleason score actually is throughout the tumor. In some cases the Gleason is downgraded with the pathology report. As you have seen there are a lot of G8 & 9 guys here who had great outcomes with surgery and organ contained pathologies.
 
As you reported in another thread your URO was not helpful at all with his short 10 minute consult and as many here recommended you need to fire him. If your husbands GP says he is healthy enough for surgery he should be more on top of his condition and health than the URO. With the Australian health system you may have limitations on URO choices but that is another subject to deal with. We have several active Aussie members and hopefully they will connect with you for more advice.
 
Terry
AGE 61 Dx with fam hist of PC
PSA
1.5 5/09
2.5 6/10
3.5 12/10 ref URO
5.25 2/11 DRE Neg
BX 4/13/11 2 of 12 cores diag both sides 15% & 20% GS7(3+4)
RALP nerve-sparing 6/8/11 path G7 pT2C, Marg-Lymph-Sem-Vas-PNI- organ confined 60% tumor involved 69grms 4.3X4X3 cm
100% dry 7/3/11
post PSA
8//11 <0.07
12/11 <0.04
3/12 <0.01
TRIMIX therapy for ED seeing improvement

Inspector 13
Regular Member


Date Joined Feb 2011
Total Posts : 144
   Posted 6/17/2012 9:53 AM (GMT -7)   
Picco, it sounds like you need to find a urologist who will take more interest in your husband's situation. If you can do that, then the doctor who is caring for your husband's current condition and the new urologist can get together to discuss the feasibility of surgery as an option. I had quadruple heart bypass surgery in August of 2009 and a robotic RP in January 2010. The G number was 6 and a PSA of 5.2. Both surgeries went well and I've been given PSA's as 0.00 since the RP. A stroke and quadruple bypass are far different situations but both are major issues. Don't rule out surgery as a possibility unless one or both doctors you feel confident with believe that it may have unacceptable risk.

Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1185
   Posted 6/17/2012 2:31 PM (GMT -7)   
Picco, it will help if you bring your husband's information over from the other thread.  Then putting it in your "signature" means you don't have to keep repeating it.  It also helps all those who want to answer your questions.  The treatment from that doctor was rude and abrupt.  Ron and I spoke to his urologist for more than a hour.  He answered all of our the questions.
 
An38 is from Sidney; I don't know if she would be helpful to you?  Prayers that your husband will get the treatment necessary for his road to recovery.  My thoughts are with you both!
 
Kathy, it is good to hear your husband is doing well!
 
Much peace of mind,
Aimzee
Husband Ron, age 63
4/1/10 PSA 5.5 Prostate size = 50 grams
Biopsy on 4/20/10 12 samples. Adenocarcinoma: 3 positive cores on right side - No Perineural Invasion Gleason 6 (3+3) Bone Scan/CT Negative 8/18/10 - Da Vinci Prostatectomy. Post Op: Gleason 7 (3+4) Negative surgical margins & lymph nodes. Both nerve bundles spared. ED a problem /No incontinence. Testicular pain. 10/11 PSA 0.01

rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 946
   Posted 6/17/2012 7:09 PM (GMT -7)   
I am repeating what the others have said. Stats are below. I was G8 post op. lots of factors to determine if you are a candidate for surgery.
Age 48 at diagnosis
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy March 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - Houston, TX (Methodist Hospital)
Pathology report -gleason 8, clear margins
PSA since surgery <.04
continent at 10 weeks (no pads!)
ED is still an issue
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