Now some other parameters, plodity tests that could be done, on your pathology which costs addtional money and you can get the info. There are 3 types of plodity-this is different than Gleason scoring stuff, (the dna structure of the PCa cells, the first type is diploid which is more similar to normal cells and it has two strands of dna alike is what my old-guy CRS memory is telling me right now, the second one is aneuploid which is more randomly structure and does not respond to hormone therapies probably as well as diploid, the third type is something like teteraploid(spelling?) or such and it is the worst plodity, random crazy insane cell structures that can get more crazy and may have no response to hormone therapies or very limited.
Yes you can have multiple Gleason scores going on with your gland at the same time, I have 3 different scores and on both sides of the gland, the same crazy 3 sets and finding almost identical. Also, realize many times Gleason grading upon review can end up higher than the original patho-doc found, and occassionally vice=versa.
If PCa cells have a way to travel i.e. perinureal invasion and such, it is conceivable that a Gleason 5 or 6 could travel beyond the gland and apparently such has happened to patients.
Now the other thing, why you need expert pathologists like Bostwick, Epstein, Oppenheimer, et al a few others too. Their are about
18 different variant types of PCa, not everyone has the same one, certain one(s) are more common. Their are a few of these that are very aggressive and prognosis is terrible on, i.e. small cell PCa and maybe 4+ others. An expert patho-doc is your best chance to know, which one you are dealing with, I have not heard of multiple types of PCa in a patient, but that may be possible too.
It is stranger than fiction with PCa, welcome to the 'twilght zone' and the jungle. Not meant to scare anyone, but to inform of what is the reality of this PCa world. I do hope you and others do well and hopefully find cures or atleast longevity. This cancer seems cureable and tameable sometimes, probably good to keep your guard up, even if you looked cured 5 yrs. down the road, do not take it for granted is decent advice.
Myself-doing better than I thought I would 7.5 yrs. ago with high end stats.
Dx-2002 bpsa 46.7 12/12 biopsies all cancerous, 70-95% ranges in everyone, gleasons found 7,8,9's on both sides, total urinary blockage-emergency room, protocol-adt-3 prior to radiations (2-types-neutron & photon) a rare gig, on/off hormone therapy, off all drugs 2 yrs., resumed DES, psa varies from .35 to .90 range (for about 2 yrs. now). Noted: no real side effects to deal with since dropping adt drugs back in 2004-5, have myself back in decent shape, decent energy and feeling well, something that was lacking when loaded on adt3 drugs.
Post Edited (zufus) : 10/5/2009 11:47:28 AM (GMT-6)