Just Diagnosed with Gleason score of 6

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Gleason 6
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Date Joined Mar 2011
Total Posts : 876
   Posted 3/29/2011 7:00 PM (GMT -6)   
What can I expect?  I'm scared.

Mackattack
Regular Member


Date Joined Jan 2011
Total Posts : 78
   Posted 3/29/2011 7:13 PM (GMT -6)   
Gleason,

Tell us a little more about yourself and your diagnosis. Age, number of cores taken and how many positive, etc. These things make a big difference.
PSA 3.9 - October 2010 at annual physical
PSA 4.1 - November 2010 after a month of antibiotic, DRE Normal
Age 41 in December 2010 at Dx of 6 of 12 cores positive T1C and Gleason 3 + 3

open RP on 2/14/11 at Mass General

Post Surgery Pathology Report: Gleason 6, T2, Cancer in 35% of Prostate, All Margins Clear

Gleason 6
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Date Joined Mar 2011
Total Posts : 876
   Posted 3/29/2011 7:18 PM (GMT -6)   
6 out of 40 positive. My psa went from 4.5 to 5.7 in 6 months and then to 7.1 in 3 months. I'm 61 years old. My hips have hurt for a year and I'm wondering if that may be from the cancer and I wish I would have known that hip pain could be from prostate cancer.

medved
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Date Joined Nov 2009
Total Posts : 1096
   Posted 3/29/2011 7:39 PM (GMT -6)   
VERY unlikely that the hip pain is from metastatic prostate cancer, with that psa and a Gleason 6 tumor. That is the lowest grade of prostate cancer that doctors diagnose these days.

Obviously you have some work ahead of you, to learn more about your disease, consider the various treatment options, and proceed with a treatment. And you will no doubt get a lot of good advice here from compassionate and knowledgeable people. But let me start with what might be the most important thing you can know right now: VERY few people with Gleason 6 tumors die of prostate cancer. You will beat this.

Having said that, here's a little concrete advice: (1) don't rush into a treatment out of fear -- take your time to explore the options and pick an approach that you are comfortble with, after investigating the alternatives; (2) consult a urologist who is a very experienced expert who has treated many hundreds of prostate cancer patients, and ask lots of questions; (3) also consult a radiation oncologist who has particular expertise and deep experience treating prostate cancer patients (radiation oncologists offer different treatments than uroglosits -- you want to talk with both so you understand the various alternatives and can then decide how to proceed); (4) get a copy of your biopsy report so you have all the details; (5) consider seriously getting a second opinion on your biopsy slide reading from a nationally known expert in prostate cancer pathology -- we can provide names if you need them -- this is important because you will make a treatment decision in part based on this reading, so you want to make sure the reading is right -- and a second opinion from a prostate cancer patholoy expert is the best way to do that, in my opinion; (6) do a little reading on prostate cancer, so you can learn more about it -- it is good to be knowledgeable and with a Gleason 6 tumor it willl also show you that you have a cureable disease -- we can suggest some books if you want -- dont get a ton of books nd subject yourself to information overload -- just one or two good books; (7) ask questions here -- you will get a lot of good advice -- but keep in mind that we are not doctors, so just use us for some ideas.

Sorry you have prostate cancer. But you will be OK. Best wishes, Medved

gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 360
   Posted 3/29/2011 8:02 PM (GMT -6)   

When I was diag almost six years ago, my urology told me oh that is nothing.

I almost kick his b,but I think he was right.you will be fine. yeah


DIAGN=46 YEARS
GLEASON=3+3
FATHER HAD PC,THEN I THEN MY BROTHER STILL HAS TWO BROTHER PC FREE.
MARRIED,TWO CHILDREN.AGE 13 AND 8.
LAPROSCOPY SURGERY 6/2005
PATOLOGY REPORT.
GLEASON=3+3
TUMOR VOLUME=5%
LYMPHOVASCULAR INVASION=NEG
PERINEURAL INVASION=POSI
TUMOR MULTICENTRICITY=NEG
EXTRAPROSTATIC INVASION=NEG
SEMINAL VESICLES BOTH=CLEAN
MARGIN ALL=NEG
PT2ANXMX
DEVELOP SCART TISSUE AND NEEDED A SECOND SURGERY BECAUSE COULD NOT URINATE,
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
0.04,10/09,0.04
 

Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 3/29/2011 8:11 PM (GMT -6)   

Hi, and welcome.  While it might not be comforting right now for me to say "don't be scared", what you will learn is that prostate cancer (PC) is among the more common and less lethal malignancies, yielding a large population of survivors.  In fact, not just "survivors", but also "thrivers" (more about that term later).

What you need to do now is to embark on a new journey of education...learning as much as you can about prostate cancer as possible.  If in a week or so you should feel like you are drinking from a fire hose...that's about the normal reaction.  Just two days ago, we were discussing the importance of education in this thread (now listed about one page down in the index of threads) titled, "Why men need to be educated" (click HERE to go to that thread to see why many here think this is important).

You'll get opinions and inputs here, but you should also go online and buy the best reference book available, Dr Patrick Walsh's "Guide to Surviving Prostate Cancer." (LINK to Barnes & Noble; for under $20 you can have it shipped to your home tomorrow).  You will soon learn that Dr Walsh is among the highest respected prostate cancer surgeons.  There are other 2nd-tier books available, but every man with PC should have the Walsh book as a reference.
 
Good luck as you embark on your journey.  We'll be here to help.
 
[By the way, your PSA rise is somewhat suspicious of a combined affect of PC and prostate infection, which can occur simultaneously.  Did you doctor mention this, or attempt to treat you with antibiotics.  To a certain degree, the point is somewhat moot because of your biopsy findings, but future use of your PSA values will be much less meaningful if the values are convoluted.]
 
[Also, I would agree, as would the American Urological Association, with the earlier suggestion that your bone pain is unlikely due to your PC.  The AUA does not even recommend a bone scan in clinically localized cases with PSA less than 20 ng/mL.  Check their documentation HERE on page 34 of their free online PSA "Best Practices" reference; another good learning tool.]


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/29/2011 8:17 PM (GMT -6)   
Gleason6:

Hello and welcome to our online community. You have been given some great advice already. Don't let the fear of the cancer taint your decisions. Take the time to learn what you can learn. I too, would highly reccomend the Walsh book, I read it all a full year before my diagonosis, and it really helped me come up to speed.

Remember, there aren't any stupid questions, so ask away, the combined experience here is amazing.

Good luck and keep us posted.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 264
   Posted 3/29/2011 8:25 PM (GMT -6)   
Welcome aboard,

If you are in the Chicago area there is a PC support group meeting next week, April 6. I will post more info on it next week.
age 57 2/2010
PSA Feb 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA Oct 3.97, Dec 2.78, 3/9/11 2.42

geezer99
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Date Joined Apr 2009
Total Posts : 990
   Posted 3/29/2011 8:41 PM (GMT -6)   
Every single person here has had that "hit upside the head" feeling and been scared sh**less so we know what you are going through.

What should you expect? A lot of confusion, a bunch of decisions, and a long happy life.

The advice you have been given is good. Let me add one point -- be sure to add your wife or significant other to the mix. I was an absolute jerk thinking that I was in this alone. When I started having my wife come to appointments with me, things got much better!

davidg
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Date Joined Feb 2011
Total Posts : 4093
   Posted 3/29/2011 9:09 PM (GMT -6)   
Gleason 6 -

This is the lowest you will be. As of tonight, after reading here and then getting more and more information you will change your attitude, slowly come to terms with your new reality and then fight hard and win. You'll win because as others above have said, this is a very treatable disease and your numbers are low.

Once you decide what course to take you will feel further empowered. Once you have gone through that process, whatever it might be, you will be able to put this all behind you and start looking ahead again.

If you have a spouse or partner, keep her/him involved in the process. It's critical to share your feelings and fears with your loved ones. They'll help make you stronger and help you make rational choices.

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2667
   Posted 3/29/2011 9:30 PM (GMT -6)   
A 40-core biopsy?  Ouch!  As a  Gleason 6, you shouldn't have that kind of pain or discomfort again until surgery, assuming surgery is your choice of treatment. 
 
You can find a ton of information just by paging through this site.  There's also a search button in the blue bar above if you want to find discussions of something in particular.  For example, you could search "bone scan" and find many entries on that topic.
 
There are also certain permanent items at the top of the main page.  These "stickies" cover a variety of topics that make good reading for anyone newly diagnosed.
 
This would also be a good time to start a journal of your experiences.  Not only will the journal make interesting reading later on, but it will help you remember information that might otherwise be lost in all the emotion and confusiion.
 
A cancer diagnosis is a very hard thing to deal with.  I don't care if it's a Gleason 6 in one core, or a Gleason 9.  It can shake you to your very core.  If you find yourself becoming depressed, or if you wonder why you suddenly find yourself crying, please realize these are reactions that should be expected and which many or most of us have gone through.
 
I absolutely agree with all of the advice that's already been offered.  You may also find that you suddenly notice many other men who are dealing with prostate cancer.  That's been my experience.  I'm not sure why I never noticed before, but in the seven months since my surgery, a couple of good friends here in town, a distant relative by marriage, my old college roommate, my cousin's husband, and one or two others have been diagnosed and/or treated for prostate cancer.  I'm happy to say that so far all of them are doing very well.  Of all these guys, only one had a biopsy that turned out to be negative.  Gleasons ranged from 7 to 23.
 
Good luck to you, and please keep in touch. 

Post Edited (clocknut) : 3/29/2011 9:38:10 PM (GMT-6)


John T
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Date Joined Nov 2008
Total Posts : 4229
   Posted 3/29/2011 9:32 PM (GMT -6)   
G6,
No reason to fear; the death rate for a treated G6 is .0003. this is about the chance of getting hit by lightening. Prostate cancer is a disease that runs a spectrum from being harmless to being very agressive. Your stats indicate it being much closer to the harmless side than the dangerous side with only 15% of your cores being positive.
Pick up a copy of "Invasion of the Prostate Snatchers" by Dr Mark Scholz for a good description of low risk PC.
You have every option available, doing nothing, surgery, seeds and radiation and depending on your biopsy, focal treatments. Each will work well in your case, but side affects are very different. You have time to throughly review all of your options and get 2nd opinions from different fields of practice.
The only mistake you can make is to make a fast decision without investigating all options available, as in many cases the cure is much worse than the disease.

JohnT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 3/29/2011 10:23 PM (GMT -6)   
G-6, just one thing, that 40 core biopsy is very accurate, but as others have suggested, get an expert second opinion on the slides..Your PSA velocity is pretty high and sometimes biopsies don't tell the whole story..While JohnT offers sound advise, he has three to many zero's in his survivability figure..You have low-risk cancer but you can't be Pollyanna about it...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

GOP
Veteran Member


Date Joined Dec 2010
Total Posts : 657
   Posted 3/30/2011 4:57 AM (GMT -6)   
Gleason,
Once you realize that this is a very treatable disease, the next step, as John T says is to decide WHEN, and HOW to treat it. This is where I feel many guys make a hasty decision. Time is usually on your side. The decision is ultimately yours, but do yourself a favor and educate yourself on ALL forms of treatment. I strongly suggest a book called Surviving Prostate Cancer Without Surgery by Bradley Hennenfent.
We 'seed' guys are a very small minority here, but we seem to  be a pretty content group. Speaking for myself, I am grateful every day that I chose NOT to have surgery. Having said that, you must, of course, be a good candidate for any treatment that you choose IF you need treatment. Good luck to you, Guy.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 3/30/2011 5:11 AM (GMT -6)   
Hello Gleason and welcome to HW.  Sorry you have to be here but you will find lots of good advice and support on this site.  Rather than be repetitive at this point I will just suggest you go back and re-read the posts by medved and JohnT.  Their advice seems very sound to me...it looks like you have lots of options and chances for a cure with good QOL are high.
 
Best wishes,
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

John T
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Date Joined Nov 2008
Total Posts : 4229
   Posted 3/30/2011 5:38 AM (GMT -6)   
Fairwind,
The number is correct.
Eggner et al. Addition to the Katin Nonograms:
 
3 0f 9557 patients died with organ confined G6 in 15 years =.0003
For all pathologicallicy confirmed G6, 15 year mortality was .002 to .015.
 
JT

Gleason 6
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Date Joined Mar 2011
Total Posts : 876
   Posted 3/30/2011 7:32 AM (GMT -6)   
Oh my gosh.  Thank you all for your comments and support.  I really appreciate it.  I'm kind of on the dark side of things right now and trying to work things out in my mind.  I noticed yesterday that I have lost about 7 pounds or so, so I wonder if the cancer has spread and I have a tumor that is sucking up my nurishment.  I have read all that I can on the web and will

definitely get the books that you all have recomended.  It's just going to take some time to sink in.  I took a  long walk on the beach with my dog and shed a few tears yesterday.  I don't really feel sorry so much for my self as I do for my wife and kids (12 and 16) and having them have to deal with this.  I have not told my kids yet as I want to find out where I stand first.  I just found out yesterday that I have the cancer and have not yet met with the doctor to find out what the next step is.  I would think I would want to get a PET scan (?) to find out if I have cancer anywhere else.  My wife is very supportive, but it's all new to her too.  After we determine what I am dealing with I definatly want to get a second opinion and get the best doctor I can find.  I don't want to get ahead of myself, but IF the cancer is confined to the prostate, has anyone had experience with proton radiation?  I guess right now I have to stop my mind from racing and get all the tests I need to and see where I stand so I can make as informed decision as I can.  The bit** is that I had a physical a year and a half ago (I have a physical every year) and the doctor did not do a PSA in the bloodwork.  Then this year my level was up.  When I asked him why no PSA the year before, he said "Oh, I must have missed a check mark when I order the bloodwork".  Boy, I know hindsight is 20/20, but I wish I had caught his sooner.  Thanks again.

Post Edited (Gleason 6) : 3/30/2011 11:32:23 AM (GMT-6)


clocknut
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Date Joined Sep 2010
Total Posts : 2667
   Posted 3/30/2011 7:38 AM (GMT -6)   
I lost a lot of weight after being diagnosed and asked the doctor if I had cachexia (cancer-caused weight loss).  First, he was surprised I knew the word, but then he smiled and explained that with prostate cancer, I would have to be in the end stages of the disease to have that happen, and I'm sure you don't have to worry, either.
 
As I said in my earlier post, a cancer diagnosis is a serious blow to the psyche, no matter what people say about it "only" being a Gleason 6 prostate cancer.  The appetite goes away, and maybe nervous energy sets the body's metabolism into high gear.
 
I think you can relax on this one.  By the way, the 20 pounds I lost prior to surgery has now found its way back home.

davidg
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Date Joined Feb 2011
Total Posts : 4093
   Posted 3/30/2011 7:41 AM (GMT -6)   
you probably won't need any scans with your low score.

You could meet with great docs in different fields so you can get a good perspective on each.

You did catch it early. You'll be fine.

Telling the kids was the hardest thing to do. Furthermore, I have a sister in law dying of very severe cancer. My kids associated my situation with hers. I had to explain to them how curable this was. I won't lie though, it affected them.

This can also put a strain on a relationship with spouse, so keep an eye on that. My only advice is to allow her to be completely involved and in tune with everything going on in your head.

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2667
   Posted 3/30/2011 7:43 AM (GMT -6)   
Obviously, your doctor should have had your PSA checked last year, but believe it or not you may one day find yourself thanking him for not doing so.  You've gone a year without side effects of any treatment and without any worry about cancer, and you've still caught it at what appears to be a very early, very treatable stage.  Please try to relax.  Things are going to work out well for you.

JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 3/30/2011 9:14 AM (GMT -6)   
G6,
 
Lots of good advice so far. I will only add this:
 
If possible, take your wife with you to all future consultations/appointments. It will help both of you understand your options better and how you want to proceed. Stress to the kids how treatable PC is with a lot of success. 
 
And finally,walking on that beach with your dog is always a good idea when you need to shed a little stress.
 
Age 68 PSA 4.5 Biopsy 9/4/09 Bostwick Labs 5 of 8 sections (5 of 11 cores) positive-Gleason 3+3=6 Stage T1
BT on 12/11/09 (84 seeds of Palladium 103) Home same day/no catheter. Some burning, frequency, urgency for 6 weeks. No incontinence, mild ED. Normal activity within 3 days. 25 IGRT sessions ending 3/22/10 - some fatigue until 30 days after last treatment. PSA as of 12/9/10 - 0.1

Gleason 6
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Date Joined Mar 2011
Total Posts : 876
   Posted 3/30/2011 9:52 AM (GMT -6)   
Good advice about my wife. I am fortunate to have a loving and supportive wife and will and have included her in everything so far. I think it's a good idea for support and just to have another set of ears to listen to the information I receive and another person to ask questions that I do not think of.

John T
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Date Joined Nov 2008
Total Posts : 4229
   Posted 3/30/2011 10:46 AM (GMT -6)   
G6,
The only things that scans will do for you is lighten your wallet. You had a 40 core biopsy and that is about the best procedure you could have had to determine the status of your PC. If there was no nodule felt it is extremely unlikely that the cancer has spread. This is just a small bump in the road of life; don't let your mind play tricks on you. You have low risk cancer that can be easily treated or watched without danger of death. You will die someday, but it is very unlikely that it will be from PC.
JohnT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Fairwind
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Date Joined Jul 2010
Total Posts : 3748
   Posted 3/30/2011 11:51 AM (GMT -6)   
Different studies produce different statistics, but still, very few Gleason 6 guys die from prostate cancer.. Since todays treatments are greatly improved from when these men were treated, your odds are even better..You are more likely to WORRY yourself to death! Don't fall into that trap..

"have now published a retrospective analysis of data from 753 men aged between 40 and 64 years of age who were diagnosed with prostate cancer between 1993 and 1996 in King County, Washington. Prostate cancer recurrence and/or progression was determined by using a follow-up survey and medical record review. Mortality and cause of death were obtained from the Seattle-Puget Sound Surveillance, Epidemiology and End Results (SEER) registry."

The study showed that:

* 65/753 patients (8.6 percent) actually died of prostate cancer during a median follow-up of 13.2 years.
* The 10-year prostate cancer-specific survival rate categorized by Gleason score was as follows:
o Gleason score 6 or less — 98.4 percent
o Gleason score 3 + 4 = 7 — 92.1 percent
o Gleason score 4 + 3 = 7 — 76.5 percent
o Gleason score 8-10 – 69.9 percent

The big issue now is surgery or radiation...Read, ask, learn...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 3/30/2011 1:33 PM (GMT -6)   
I'm scheduled for a CT/bone scan of the hips and pelvis on April 12th. Not that I don't appreciate the advise to the contrary, but that is what the doc recomends and I think I would like to know if it has spread. I also have just about met my max out of pocket for insurance.

Post Edited (Gleason 6) : 3/30/2011 1:37:59 PM (GMT-6)

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