Some of my thoughts on this subject:
A standard biopsy at best, is just an estimate. It took 2 no cancer ones with me to lead up to #3, which struck pay dirt. The only reason there was a #3 2 months after #2, is because my dr was experienced enough to trust his gut feeling, he knew something was wrong, and he said he saw a shadowy area in the left side of my prostate. With my rapidly rising PSA, and no other prostate problem symptons, and clean DRE, he knew it was there, somewhere. So #3 was targeted to that area, and bang, 7 cores, 7 positive.
I wish the first biopsy would have found it, I could have been a low grade 6 instead of a pissed off gleason 7.
My GP went by the old standards, not his fault, dont do anything till the patinet hits 4.0 psa. The first time it did, off to the urologist I went.
I agree with a poster above, if your biopsy shows you a 6, then assume it might be an 7. Look just at the stats in our own group, many men were upgraded after surgerey, some stayed the same, and even rarer, the final gleason went down. On the staging side, many were upped to the next grade of staging after surgery.
This will sound like a plug for surgery, but that is a major reason to have surgery ,so the entier prostate can be examined and the other removed parts to give the patient a fuller and clearer picture of where they stand. Something to think about
They should write a whole book on Gleason 7 situations. Even my own dr gave me a lecture on the erratic way a 7 can act. He said in t he begginning, that a 7 is too dangerous to wait and watch. He firmly believes that a 4+3 will act much more agressive like a gleason 8, while a 3+4 can act more like a high end gleason 6. Its the amount of type 4 in the mix that is determining the agressiveness of the cancer
From my many studies sources and based on the doctors I have spoken with, overwhelmingly they reccomend that gleason 7 cases go to surgery first if the general health of the patient is suitable for surgery.
If it were up to me, PSA testing should be required of all men by age 40 to get a base line. Age 30 if one is African-American and/or have a directly linked relative with PC, i.e. dad, brother, uncle, grandfather. We could save a lot of lives that way.
A cheap blood test doesnt boost up health care costs as much as expensive treatments, long term advance care, hospice, or even the cost of a funeral when one of our dear brothers gives up the ghost to this hell of a cancer.
We need a knowledgable major level Prostate Cancer Czar, that will keep our blight on the front burner in the news, and help eliminate all the idiotic articles about
over treatment, testing too much, us having the good cancer, etc. And to push for faster approved drugs for our advanced brothers, and better testing methods that would give the next generation of brothers a better fighting chance then we have.
I will shut up now. Vented enough.
David in SC, I take comfort every day that I am dealing with the "good cancer". LOLLLLLLLLLLLL
57, 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
Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes
2009 PSA 2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18,
meeting with Rad. Oncl on 8/14 about lastest PSA
Post Edited (Purgatory) : 8/14/2009 7:07:44 AM (GMT-6)