Gleason score

Diagnosed with prostate cancer last week. PSA was 5.6, Free PSA 23 (a year ago 4.8 and 27). Doc took out 12 samples; two were malignant, two others were suspicious. Gleason score was 6 ... Had CAT scan and bone scan this week; waiting for results. I am 59 ... How does that Gleason score of 6 compute with the likely spead of cancer outside the prostate?

Hello,

I think you are in good shape. A gleason of six is very good. Also, your PSA numbers are low; I think you are going to be fine.

Good luck.................Shepper.

I was also diagnosed last week. PSA was 9.4 (up from 4-something a year or two ago), Free PSA 5%. Of 12 samples, two show malignant with Gleason 3+3=6. Just booking CAT and bone scan. I am 62, in seeming good health, and have absolutely zero symptoms.

Any similars?

Had my CAT scan last week; bone scan Monday. Tomorrow I meet with my urologist. It's kind of weird: because the good news will be that I have JUST prostate cancer. When I completed my bone scan, the tech told me that it looked good, that he didn't see any abnormalities other than some arthritis in the knee. But he asked me to take a seat in lobby because the doc at the radiation clinic would need to review the scan. So I'm thinking I'm in good shape. For about 10 minutes. The tech pulled me aside and said the doctor saw a spot on my left shoulder blade, and they took chest X-rays. Of course, they didn't tell me anything. So he might have found bone cancer ... or it was an anomoly or old injury. Hoping for the best.

I am surprised that with a gleason score of 6  you would get a bone scan unless the biopsy indicated that the cancer had metastasized (spread).

I had a psa of 7 in November 2004, in April 2005 it was 6.

In August 2005 it was just over 6 so I had my biopsy.

I had a Gleason of 6 (3+3) and 7 (4+3) and a bone scan was not even considered and I had a second opinion. Also my biopsy indicated that the cancer has matastasized.

I had a laproscopic radical prostatecyomy 5 weeks ago and the pathology report showed no spread outside. 

So, don't panic, just get the best surgeon you can find hopefully in a Cancer Hospital and with scores of 6 iI would think you would do really well.

 

 

 

The news was good. CAT scan showed only a couple of tiny kidney stones. Bone scan was fine. Doc feels spot on shoulder is old injury. Xrays were good. My urologist, who had done 100s of surgeries, wants to operate. Pretty much the standard surgery. Will need to research this a bit, and perhaps get 2nd opinion at the Moffitt Cancer Center in Tampa. I'm inclined to have the surgery, just not sure which method is best.

Elpaso,

Dr. Pow-Sang at Moffitt is excellent!

If you want you can contact me at kirkinflorida@excite.com

Otherwise, I think Moffitt is an excellent choice, thats where I had mine done.

Kirk

 

 

 

I have a consult with Dr. Pow-Sang scheduled.

Ask about the predicted outcome. I did and it was 63% success for surgery and 63% for radiation. With surgery I would have been impotent because they would have cut out everything. You may have a better chance then me so ask about the odds allways. My radiation was a totall success so far with a PSA score of 0.2. I still have to wait until my testosterone comes all the way back to normal to make sure my PSA stays down. But it looks great now. Good luck to you.

Mack,

Hope to get those kinds of numbers at Moffitt .... I have a very enlarged prostate, 77 ccs compared to a normal prostate which would be in the 20s. Will ask if that is an issue with radiation versus surgery. My dad had prostate cancer in 1988, treated with radiation. He is still alive today, with no return of the cancer. But he does not remember his PSA, Gleason score, etc.

I had a radical done two years ago. The pathology report showed a positive margin.

My first PSA 3 months after the surgery was 0.008, but over the last 20 months it has risen to 0.09. I've been told that if it gets close to 0.4 I will need radiation.

So, ya gotta live, and enjoy your life.

My urologist had inidcated to me that I would need to wait 6 to 8 weeks after the biopsy to have surgery. Anybody know why that would be the case? ... Scheduled a consult at the Cleveland Clinic on the East Coast of Florida, 1/13. Dr. Jackson is highly regarded and does the robotic surgery. I am also scheduled for consult at the Moffitt Cancer Center 2/13, also highly regarded. Just want to get this done as soon as possible.

Located information on why surgery is delayed after biopsy:

"When confronted with a positive result from a prostate biopsy, many doctors – and perhaps even a significant number of patients – may press for surgical removal of the prostate immediately, in order to prevent the spread of cancerous cells into surrounding tissue. However, a new study suggests that an immediate surgical removal of the prostate is often unnecessary in prostate cancer cases, and sometimes may even place the patient at greater risk. The study, published in the urology journal BJU International, concludes that in most cases of prostate cancer diagnosis, a minimum waiting period of two months following a biopsy test are needed to allow biopsy-related inflammation to subside, improving the prospects for full recovery. The study's authors noted that the two-month waiting period did not appear to increase the risk of the cancer's spread."

Gleason = 7, PSA = 40 Urologist says too aggressive for surgery (radiotherapy not on because of crohns)
Hormone therapy for 2 years PSA = 0.02 so far so good.
Although as I am 54 years old I am concerned for the long term on this treatment.
My urologist obviously can't make promises but assures me that some people have survived for many years with this treatment.
Radiotherapy apparently might be an option if/when hormone stops working, but this is a problem with the crohns and might require a colostomy.
Any similar cases out there ?

A gleason of 6 indicates a less aggressive cancer which implies a lesser likelihood of metastasis. A gleason of 7 would be of greater concern.

I'm scheduled for laproscopic surgery March 7 at Moffitt Cancer Center. Dr. Julio Pow-Sang, who has an excellent reputation, will perform the operation. He said about 8 percent of his surgeries have to be converted to regular open procedure. I'm hoping for the best - my prostate is very enlarged, 95.6 ccs, and I now weigh 265 pounds. Have dropped 10 pounds in recent weeks; have been walking 5 to 7 miles a day to build up stamina. Was hoping to have robotic laproscopic surgery done, but I could not get it scheduled in a timely fashion.

It's been an interesting two months. I had a consult at the Cleveland Clinic and the doctor there said I was not a candidate for robotic surgery because my prostate is too big and I was too large. But in doing my own research I found a number of doctors in Florida who have successfully used robotics on large patients with very enlarged prostates. One doctor in Ocala has developed special instruments for large patients. I would have used him, but he does not take insurance - the bill is $15,000 to $25,000 for a robotic laproscopic operation.

I had scheduled an open procedure with my urologist, who is skilled. But Moffitt said it could do the less invasive surgery. So I cancelled the rrp ... Had my pre-op in Tampa today ... Doc says I will have the catheter for two weeks. Ugh.

ocash,
really pleased its going well for you.
unfortunately my cancer has spread to the bone in the hip joint.
I have had a second opinion from one of the senior consultants in "the beatson clinic" in glasgow, which is as good as it gets over here.
I do agree that I am a bit young for hormone dependancy but with all my other ailments I am just making the best of it, I just keep fighting and hoping for the best.
Like most people on this site hope springs eternal and I try to remain optomistic.
again thanks for your good wishes it's really appreciated.

Just got my husband's bone scan and needless to say I am going crazy. His scan report says he has increased activity in the naterior aspects of the 5th, 6th, 7th rib and focal increased activity is also seen in the manubrium (top part of the sternum) and in the 10th rib.. The 10th rib looks like old fracture. They also said the abnormal activty in the left anterior ribs is diffused and not typical of trauma. What does that mean? An x-ray of ribs & sternum is suggested. Has anyone had something like this. My hushand had a PSA of 11 but went to 9.97 after antibiotics. The biopsy is a Gleason 6. NO tumor was felt. Can anyone let me know if they had similiar reports. A doctor I know said very unlikely that is anything with a PSA even when it was 11 and a gleason of 6. Please let me know. I need to calm down beofre we go for the x-ray...

Just wanted to comment on what one of the posters said above (i.e., why perform a bone scan if the biopsy does not show any metastases)? To the best of my knowledge, a biopsy only helps to project the Gleason score and stage of cancer based on the cancer found in the test samples taken of the prostate--it does not reveal whether or not the cancer has spread beyond the prostate (i.e., metastases). If the Gleason score is lower (usually 6 or under) is it generally assumed that the cancer has not escaped beyond the prostate. If the Gleason score is higher than 6, there is a greater chance that the cancer has spread beyond the prostate. However, having a bone scan and endorectal MRI are important tests to help determine the stage of cancer. Many urologists do not have these supplemental tests performed and it could be a big mistake. PCa patients should question why these tests are not being performed. It is true that both of these tests do not have 100% reliability, but they are nevertheless important diagnostic tests to supplement the biopsy. My urologist, who directs the prostate center at a major hospital, asked me to take both tests and I am glad that I did. It gave me a greater comfort level as to my stage of cancer which helped in my treatment decision.

Good luck to you Elpaso!

Dave

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68, 29-core biopsy 9/27/06, PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area],  Gleason 6 [less than 5% in two other areas], negative DRE, bone scan and Endorectal MRI. Completed 39 Proton radiation treatments 2/22/07-4/18/07.