Tony, I will make a stab here. How do you know that at first you were a 2+2? Until they did you first biopsy, there would be no way of knowing what Gleason score was suspected. Depending on how many cores were found with cancer, there could be more than one Gleason score. I.E., on my 3rd and final biopsy, some of my cores were 3+4 = 7, and some were 4+3=7, both 7's, but in reality can mean two different things. After a person has surgery,
open or robotic, to remove the entire prostate, plus usually lymph nodes, seminal vessels, etc, then they do a post surgery pathology job. When that comes back, since they should have all the material removed from inside you, the results can either be the same, or downgraded to a lower gleason (rarer in my opinion), or upgraded to a higher number (which I have seen more cases in that direction). To go back to your question, the only way to know anything about
your Gleason, is either through a biopsy (or several), or post surgical pathology after you have had an operation. That would be the general rule.
The 2+2 confuses me, as I have never heard of that as being a PCa dx. Again, not a doctor, could be wrong. Even a 3+2 or a 2+3 is unusual. Most PCa dx seem to be a 3+3 or a 6. The biopsy, at best, and depending on how many cores they take, is at best, an estimate of what they think is going on inside you.
You stats do concern me, particualy your right side with the 4 of 4 positive, 40% cancer , and a gleason 4+3. If this ends up being the case after treatment, then it definitely needs to be dealt with sooner rather than later, and no, not steering you into any particular treatment.
Hope this info helped, and if I am wrong, please someone correct me.
David in SC
56, 56 at DX, PSA
7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes
First PSA Post Surgery 2/9 .05