Aggressive vs Advanced PC ?

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2455
   Posted 3/25/2009 8:07 PM (GMT -7)   
I've been reading the "Surviving PC" book and they talk about "Advanced cancer". Does a high Gleason score normally described as aggressive cancer mean the same thing? Or does aggressive mean that it has metastasized?
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Bilateral
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/25/2009 9:41 PM (GMT -7)   
Hi Ed,
High Gleason's (8-10) are high risk disease unless the tumor has escaped the prostate capsule. The reasoning is that they are more susceptable to recurrence or progression. Advanced Prostate Cancer is debated depending on where you read it. But it typically is cancer that has advanced beyond the prostate. Some institutions call it locally advanced if metastasis (mets) are not located in bones, angiolymphatic system, distant organs, or imaging scans.

For me it was called advanced because I had 4 positive margins, seminal vesivle invasion (SVI), and identified progression near the rectum. Yours could be called locally advanced or advanced in some institutions, but for the purpose of treating it, high risk locally advanced prostate cancer would likely be used.

Most institutions differ locally advanced PCa from metastatic, or progressive prostate cancer when deciding on treatment options. Metastatic prostate cancer requires systemic treatment as do many T3 patients...

For patients who had surgery:

pT2x = Local contained prostate cancer. T2c can have a focally positive border in the capsule but no extraprostatic extention (EPE) ~ Stage II
pT3a = Focally positive margin or EPE. ~ Stage III
pT3b = EPE, positive surgical margins, or SVI ~ Stage III
pT4a = Metastatic prostate cancer spread to one or more local lymph nodes ~ Stage IV
pT4b = Metastatic prostate cancer spread to bones, distant organs or lymph nodes. ~ Stage IV

I hope this helps...

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 3/26/2009 7:12 AM (GMT -7)   
Gleason 7's can be more confusing. As a rule, if you have a 4+3=7, they can act more like a Gleason 8, which is obviously much more aggressive. If you have a 3+4=7, they sometimes can act like a Gleason 6, which normally is less agressive and slower moving, and less likely to escape.

In a 7, it all comes down to how much type "4" cancer cells are found in the biopsy or post surgical pathology.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 6 month on 5/9
 
 


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2455
   Posted 3/26/2009 10:09 AM (GMT -7)   
Thank you TC-LasVagas and Purgatory. Your explanation is excellent.
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Bilateral
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean

New Topic Post Reply Printable Version
Forum Information
Currently it is Monday, February 19, 2018 5:16 AM (GMT -7)
There are a total of 2,930,803 posts in 321,568 threads.
View Active Threads


Who's Online
This forum has 160303 registered members. Please welcome our newest member, Angelrose.
313 Guest(s), 4 Registered Member(s) are currently online.  Details
RedLabel, tickbite666, FamilyGuy, testuser1234