Gleason question

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 11/15/2009 9:34 PM (GMT -6)   
In looking at the postings, the minimum Gleason seems to be 3 +3.
 
Is that the lowest there is? Is a lower score considered non-cancer?
 
Mel
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
 
History of BPH/prostatitis.
 
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 11/15/2009 9:44 PM (GMT -6)   
I think that the lowest Gleason is 2 (1+1) and I do not think that you get a Gleason score if you do not have PC I had a Gleason score of 5 after my biopsy but it was upgraded to 6 after surgery
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 11/15/2009 9:52 PM (GMT -6)   
There used to be a lot of Gleason 5s reported, but most of it was so low grade and not harmful that pathologists rarely report it anymore.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/15/2009 9:59 PM (GMT -6)   
Gleason Scores would range from 2 (1+1) to 10 (5+2), but in most cases, a Gleason 6, normally in the configuration of 3+3 would be considered a full PC dx.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 11/16/2009 12:52 AM (GMT -6)   
I was told by a uro oncologist that cells of Gleason 1 and 2 are just considered to be abnormal cells. The first time they're called cancer is when they are 3, or above.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    


dogbot
Regular Member


Date Joined Aug 2009
Total Posts : 147
   Posted 11/16/2009 4:35 AM (GMT -6)   
I was told at my original biopsy that a gleason 3+3 is the lowest they give you as a positive result from a needle biopsy. But of course you may have different criteria in the States. All the best from England.
Diagnosed February 2009. Gleason 6, Psa 7.2, 12 core biopsy, and then Mri scan, which showed organ specific.
DaVinci at Addenbrookes, Cambridge, England 18th May 2009.  Nerves removed one side.
Catheter in for 8 days, no pain, no post op problems apart from an infection, cleared with antibiotics.
Some aching around the penis, which still occurs.
6 week psa 0.1, post op pathology all good, confirming pre op tests. Ed a problem, no treatment as yet.
Light ladies pad during the day, just to control a slight dampness and a Tena for  men pad at night for occassional leakage.
Awaiting 3 month consultation at the moment.
Sept 09 - still awaiting consultation. 99% dry during the day, tena pad at night just in case.
Sept 18th 09. PSA less than 0.1
Sept 29th follow up consultation at Addenbrookes. Staff happy with progress.
Nov 11th update. One small stress dribble in the last 2 months. Still some muscle stiffness in pelvic area.
 


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 11/16/2009 5:11 AM (GMT -6)   
dogbot that is OK if they can guarantee the biopsy figures I was 3+2 on my biopsy but ended up to be 3+3 after my operation so according to the English doctors in June it was not cancer but at the end of July it was cancer
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed


cocrgolfer
Regular Member


Date Joined Oct 2009
Total Posts : 171
   Posted 11/16/2009 7:06 AM (GMT -6)   
HI Mel,

I had four cores positive out of fourteen. Two of them were Gleason fives, one a six, and one a seven. Also had one area of the prostate that had neoplastic cells, which was on the other side of the cancer tumor, that they told me had a 50% chance of becoming adenocarcinoma. That was the deciding factor for me to choose surgery over radiation.

Steve

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 11/16/2009 7:07 AM (GMT -6)   
Two very big differences here

a Gleason score on a needle biopsy is a reading on JUST a sampling of cores from the prostate

The Post Op Pathology is a reading of a far greater portion of the prostate

The reading is often greater on the Post Op Path report
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 11/16/2009 9:14 AM (GMT -6)   
It is possible to have gleason score of 5(2+3)-(3+2) or 4 (2+2)and such, it is rare and depends upon what the pathology doc is analyzing and finding. The precursor to cancerous gleason scoring is from PIN cells definitions and of the high grade PIN(consider precursor), and the low grade PIN is not necessarily a precursor to PCa. This data if found should be listed within your pathology report and you need to have a copy, as the uro-doc might not mention you have PIN as (hey it is not yet PCa)...means you monitor diligently if you wish your best results.
 
 Amazingly have seen plenty of stories over the years of mistakes, errors or lousy info from docs that should never happen, this is why I chastize some of the docs and what goes on out there in the name of best medical practice in the world.  Suggest patients tell their uro-docs to send the biopsies only to the few handful of expert pathologists, why waste your money and possibly your life or prognosis on lesser experts. There is a longer list of patho-doc experts you can find out about them. Here are a couple of them:

www.bostwicklaboratories.com (Dr. David Bostwick)
You can read alot about pathology here and on:
www.prostatelab.com (Dr. Oppeheimer)
Dr. John Epstein
Dr Grignon
 
and some others but not a big list of such (fyi). I post such for your consideration. turn   

Post Edited (zufus) : 11/16/2009 7:28:30 AM (GMT-7)

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