I understand where you are coming from 150%. I am the same. A G6 with no adverse pathological features and I am still scared as crap everyday. I noticed the same thing as you on this board. People with great pathologies and then they have BCR. Obviously, they weren’t organ confined.
So, here is what I know.
These studies of G6 people from Johns Hopkins.
This study was of 2,551 men who had surgery from 1983 to 2005.
With a median follow-up of 5.0 years (range 2–22), BR occurred in 13 patients (0.5%). The 5-, 10- and 15-year actuarial probabilities of BR were 0.3%, 0.9%, and 1.3%, respectively. Five patients (0.2%) developed LR, four of whom received salvage radiotherapy with subsequently undetectable PSA. The 5-, 10-, and 15-year actuarial probabilities of LR were 0.1%, 0.5%, and 0.5%, respectively. There were no Distant Mestastasis and no Prostate Cancer Specific Mortalities.
Then Johns Hopkins comes out with this study.
The authors conclude that most prior reports of organ-confined, Gleason score 6 with progression have, in fact, been undergraded, understaged, or situations with ambiguous staging. They go on to say that, “Even for the rare true organ-confined, Gleason score 6 (no pattern 4) tumor with supposed biochemical progression, some may be false-positive progression based on low post-radical prostatectomy prostate-specific antigen levels and minute tumors that seem highly improbable to progress.”
So, even if you have BCR it is not likely to do anything. “Great, I feel cured.” NOT!
Then Sloan Kettering comes out with this study. Which showed a crappy 1.9% of people in the low risk people had metastatic progression. Notice nobody in the Johns Hopkins studies did. I don’t know what to think now.
I also have another study, I can’t find the link it is at work, that showed after 22 years only 1 person out of 3768 G6 people died of PCa. That’s a 99.97% survival rate after 22 years, although Johns Hopkins has 100% survival.
Anyway, so to further assess my situation I went to Yana-Now.net and looked at all of the G6 people on their web-site. You have to read each of the bio’s because a lot of people are classified as G6 that actually weren’t after surgery. Out of the 173 people I looked at only 5 had BCR. The furthest one out was 19 years and he has done nothing, no salvage treatment and is PSA is 4.
I also found one other story about a guy with G6 in his lung after RP. After they removed nodule his PSA was undetectable.
So, I don’t know what to think. I am only 44 and I believe I have some for of aggressive G6 because I had it so young, although everyone from my local URO to Dr. Epstein at Johns Hopkins says that age has nothing to do with it. I suppose the only solice I have is that since I went to Johns Hopkins, even if they missed things on peoples pathologies, if they say you are a G6 in their books I know what happened to each and every patient after that. Nothing......
Even with all this good data and for having cancer, we got off very, very lucky, I still loose a lot of sleep over it. Not to mention every time I have a health problem I go running to the Dr. to make sure it is not some kind of other cancer.
By the way they also told me that a PSA test once a year was "more then adaquate" for G6 people. It was like I could do it less often then that if I wanted and the ultra-sensitive is not neccessary to them and only causes unnecessary anexity. So I don't do the ulta-sensitive as long as it is <.1 I'm good.
Gleason 6 (tertiary score 0)
OPEN RP 10/08 Johns Hopkins
pT2 Organ confined Gleason 6
PSA Undetectable as of 10/15/09
Next PSA 10/15/2010
Post Edited (ChrisR) : 3/31/2010 5:05:03 PM (GMT-6)