Mixed Messages On Favorable Outcome - Gleason 8

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seeker44
New Member


Date Joined Feb 2008
Total Posts : 8
   Posted 7/21/2008 8:09 PM (GMT -6)   
As I seach the Internet about recurrence of PC after radical prostatectomy for patients found with Gleason 8, I'm finding everything from probable recurrence within five or ten years to a good chance that one will remain free of PC. 
 
Are there any folks out there reading this forum who had Gleason 8 and are still doing well at close to five or ten years after having had a RP?  If you did have recurrence, has hormone, rad or other treatment been successful in stopping your recurrence?
 
Thank you.
Nov 2007 - PSA 6.2
Biopsy Nov 07:  Three of 12 cores positive for adenocarcinoma; Gleason 3+3=6 at left apex, right lateral mid and right lateral base.
Open Surgery (RP) Feb 2008
Path Exam of Tissue:  Gleason 4+4=8
Tumor confined to prostate gland
Staging: (pTNM): pT2c pNX pMX
Margins:  Free of Tumor
Extraprostatic Extension:  Absent
Seminal Vesicle Invasion:  Absent
No perineural space invasion identified
CT Scan:  No metastasis found
1st postop PSA:  <0.10; 2nd: <0.10


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 7/21/2008 8:28 PM (GMT -6)   
i had surgery this past may. great question you are asking. i believe gleason 8 has a 14% chance of recurrence. there are some hans tables on the internet that you can input your data and get the percentage chance of recurrence. my psa has been less than .1 but am somewhat apprehensive given the gleason 8.
 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
4 week and 6 week PSA .04 (undetectible)
continence ok during day - 1 pad
night time different story
kegel's twice a day 20 reps


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 7/21/2008 8:30 PM (GMT -6)   
Hello Seeker,
I missed your coming to the forum................pity about having to be here but welcome. Apart from information that members may be able to give you, have a look at the treatment charts on the yananow forum.
www.yananow.net/Chart-Gleason.htm#gs.
You will find a quite a few experiences and treatments there with Gleason 8 and above. At times when a downer sets in it is particularly good to read the story of
www.yananow.net/Mentors/DougA.htm ,
a Gleason 10 treated by surgery in 1991 which had extra-capsular penetration and was followed by radiation. He relapsed in 1996 with a climb in PSA treated with hormone therapy. Here it is 2008 and he's going strong with no sign of PSA. Now that is a story to inspire us all.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.1 undetectable

Post Edited (BillyMac) : 7/21/2008 8:50:33 PM (GMT-6)


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 7/21/2008 8:57 PM (GMT -6)   

link to han tables.

http://urology.jhu.edu/prostate/hanTables.php

enter your POST-op numbers and it will tell you what the likelihood is....

....I entered the numbers from your profile and here is what it gave as a result:

Recurrence Probability Following Radical Prostatectomy (by Han Table)

Probability of Biochemical Recurrence
(detectable PSA level) at
3 years after surgery: 16% (6-41)
5 years after surgery: 25% (9-58)
7 years after surgery: 35% (13-72)
10 years after surgery: 43% (17-81)

All numbers represent predictive probabilities with a 95 percent confidence interval

This is why many Gleason 8-10 men have radiation or other follow-on treatment after surgery, to increase the likelihood of taming the beast.

good luck.



Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008

Post Edited (DanmanBob) : 7/21/2008 9:01:28 PM (GMT-6)


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 7/22/2008 9:24 AM (GMT -6)   

No surgery here but you ask a very good question. As a Gleason Score 10 some had my situation further advanced than now believed to be. 

This is one reason I started my site www.gleason10.com is to tell a story that a high gleason is not an automatic death sentence. 

Am I using this to cope, maybe, but I don't think so. I just feel that no one should make our problems any greater than they already are. 

Hope far out weighs dispair when it comes to helping one cope with any problem, health or otherwise.

I plan on being around to see my 12 year old grandson reach man hood and play for the US soccer team in the Olympics.

Richard


Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
Jan & Feb & Mar all tests clear
MD Anderson = No surgery and No Proton only Hormone and IMRT
Contacted with Loma Linda and UFPTI in FL
Started Treatment at the U of Florida Proton Therapy Institute in April 2008
May 2, 2008 LUPRON & Casodex
IMRT to started  5/27/2008 Will get 42 treatments 25 IMRT and then 17 Proton
Turn Stumbling Blocks into Steping Stones and Keep Smiling
Our Journey is on WWW.GLEASON10.COM
 


seeker44
New Member


Date Joined Feb 2008
Total Posts : 8
   Posted 7/22/2008 9:27 AM (GMT -6)   
Thank you for these leads and information--very helpful. God bless.
Born: 1944
Nov 2007 - PSA 6.2
Biopsy Nov 07:  Three of 12 cores positive for adenocarcinoma; Gleason 3+3=6 at left apex, right lateral mid and right lateral base.
Open Surgery (RP) Feb 2008
Path Exam of Tissue:  Gleason 4+4=8
Tumor confined to prostate gland
Staging: (pTNM): pT2c pNX pMX
Margins:  Free of Tumor
Extraprostatic Extension:  Absent
Seminal Vesicle Invasion:  Absent
No perineural space invasion identified
CT Scan:  No metastasis found
1st postop PSA:  <0.10; 2nd: <0.10

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